Year: 2010
Type: article
Study design: Case Report
Abstract: Kawasaki disease (KD) is an acute, self-limiting febrile mucocutaneous vasculitis of infants and children.Diagnosis of KD is clinical and is based on the presence of fever with other features suggestive of KD, lymphadenopathy being the least common.Retropharyngeal abscess mimicking KD has been rarely reported from India.We discuss an 8-year-old boy presenting initially with a retropharyngeal abscess and upper airway obstruction, later developing a full-blown KD, thus resulting in a delayed diagnosis of KD.An 8-year-old boy presented with fever, pain on the left side of the neck associated with restricted neck movements, and trismus for 1 day.He also had difficulty in swallowing and breathing.On examination he was febrile (104˚F), toxic, anxious, irritable, and a throat examination revealed a 4×5 cm swelling in the posterior pharyngeal wall to the left of the midline.He also had upper deep left cervical lymphadenopathy and there was no cyanosis.His respiratory rate was 48/min, and he had suprasternal indrawing and stridor.His systemic examination was normal.Investigations revealed a total white blood count (WBC) count: 20,800/mm 3 , polymorphs: 80%, platelet count: 3.5 lacs/mm 3 , erythrocyte sedimentation rate (ESR): 55 mm/hr, and a C reactive protein (CRP) of 48 mg/dL.Blood cultures showed no growth.A lateral neck X-ray revealed widening of the retropharyngeal space and narrowing of the upper airway.Computed tomography (CT) of the neck revealed ill-defined hypodense lesion extending from the C2-C6 vertebral level in the posterior pharyngeal space with no contrast enhancement compatible with a diagnosis of retropharyngeal abscess (Fig. 1).In light of the high fever and toxemia, he was started on antibiotics (Cefotaxim 100 mg/kg/day) and surgical aspiration was undertaken within 24 hours of the antibiotics and yielded Case Report
Source: Yonsei Medical Journal
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $700
OpenAlex ID: W2117889653