Document Detail

Retropharyngeal edema: an unusual manifestation of Kawasaki disease.
MedLine Citation:
PMID:  19150196     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Kawasaki disease (KD) is an acute multisystem vasculitis of unknown etiology that typically affects young children. KD presenting as a retropharyngeal inflammatory process is very rare.
OBJECTIVES: To report a case of KD initially presenting as a retropharyngeal edema mimicking a deep neck infection, and to review previously published reports in the literature.
CASE REPORT: We report a case of KD in a previously healthy 3-year-old child who presented with acute onset of fever and cervical adenitis, along with computed tomography scan findings of retropharyngeal edema and inflammation. KD was suspected due to persistent fever and no improvement in the patient's condition despite appropriate antibiotic therapy; and other classic findings of KD eventually developed. An echocardiogram obtained on the 10th day of illness revealed pericardial effusion but no coronary ectasia or aneurysm. Treatment with high-dose intravenous immunoglobulin resulted in dramatic clinical improvement. Follow-up echocardiograms obtained 2 and 8 weeks after discharge revealed a small left coronary artery aneurysm (CAA). Nine months later, the CAA had resolved and the patient was well with no sequelae.
CONCLUSIONS: Although unusual, physicians should be aware of retropharyngeal edema as an atypical presentation of KD.
Emily W Langley; Daniel K Kirse; Craig E Barnes; Wesley Covitz; Avinash K Shetty
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-01-15
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  39     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-5     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Department of Pediatrics, Wake Forest University Health Sciences and Brenner Children's Hospital, Winston-Salem, North Carolina 27157, USA.
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MeSH Terms
Anti-Inflammatory Agents / therapeutic use
Aspirin / therapeutic use
Child, Preschool
Edema / etiology*,  radiography
Immunoglobulins, Intravenous / therapeutic use
Immunologic Factors / therapeutic use
Lymphadenitis / etiology,  radiography
Mucocutaneous Lymph Node Syndrome / complications*,  drug therapy,  radiography*
Pharyngeal Diseases / etiology*,  radiography*
Tomography, X-Ray Computed
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors; 50-78-2/Aspirin

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