Risk factors for retropharyngeal cellulitis in Kawasaki disease

Abstract Objective Kawasaki disease (KD) is an acute multisystemic vasculitis of unknown etiology that occurs in infants and children. Retropharyngeal cellulitis has been reported as a rare manifestation of KD. This study investigated the frequency and characteristics of patients with KD manifesting...

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Bibliographic Details
Published in:Auris, nasus, larynx nasus, larynx, 2014-10, Vol.41 (5), p.455-458
Main Authors: Tona, Risa, Shinohara, Shogo, Fujiwara, Keizo, Kikuchi, Masahiro, Kanazawa, Yuji, Kishimoto, Ippei, Harada, Hiroyuki, Naito, Yasushi
Format: Article
Language:English
Subjects:
Age Factors
Cellulitis - diagnostic imaging
Cellulitis - etiology
Child
Child, Preschool
Edema - diagnostic imaging
Edema - etiology
Female
Humans
Infant
Kawasaki disease
Lymphatic Diseases - etiology
Male
Mucocutaneous Lymph Node Syndrome - complications
Mucocutaneous Lymph Node Syndrome - diagnostic imaging
Mucocutaneous lymph-node syndrome
Neck
Otolaryngology
Pharyngeal Diseases - diagnostic imaging
Pharyngeal Diseases - etiology
Pharynx
Retropharyngeal cellulitis
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
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Summary:Abstract Objective Kawasaki disease (KD) is an acute multisystemic vasculitis of unknown etiology that occurs in infants and children. Retropharyngeal cellulitis has been reported as a rare manifestation of KD. This study investigated the frequency and characteristics of patients with KD manifesting as retropharyngeal soft-tissue swelling. Methods We retrospectively reviewed 277 patients, with a mean age of 1 year and an age range of 7 months to 12 years, in whom KD had been diagnosed between 2005 and 2011. Results In 10 patients (3.6%), contrast-enhanced computed tomography (CECT) showed low-density lesions without ring enhancement in the retropharyngeal spaces. These patients presented initially with fever and cervical lymphadenopathy, and were initially treated by their pediatricians for suppurative lymphadenitis (seven patients) or retropharyngeal abscess (three patients). KD was finally diagnosed either after antibiotics had been ineffective or when other symptoms characteristic of KD emerged. Conclusion Low-density lesions in the retropharyngeal space were identified by CECT in 3.6% of the KD patients. Early diagnosis of KD is essential because coronary artery lesions develop in 50% of untreated patients. If a child presents with fever, cervical lymphadenopathy, and swelling of the retropharyngeal space, KD should be included in the differential diagnoses.
ISSN:0385-8146
1879-1476
DOI:10.1016/j.anl.2014.05.017