Risk factors for retropharyngeal cellulitis in Kawasaki disease

Tona, Risa; Shinohara, Shogo; Fujiwara, Kenshu; Kikuchi, Masahiro; Kanazawa, Yuji; Kishimoto, Ippei; Harada, Hiroyuki; Naito, Yasushi

doi:10.1016/j.anl.2014.05.017

Cited by 22 publications

(31 citation statements)

References 23 publications

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“…First, the presence of retropharyngeal edema occurred more often in the KD group. This is in line with previous studies that reported retropharyngeal edema as an important finding in KD patients . Second, the absence of enlarged level 4 lymph nodes was statistically more likely in KD patients.…”

Section: Discussionsupporting

confidence: 92%

“…Overall, approximately 5% of the present patients ultimately diagnosed with KD underwent CT. This percentage is similar to that reported previously . Such patients had an average 2.6 of the 6 principal symptoms at the time of cervical CT.…”

Section: Discussionsupporting

confidence: 90%

“…Additionally, patients with KD who underwent imaging were older than the general population of children with KD. While these results could reflect an intention to avoid CT in very young patients, they may corroborate previous research noting that children with lymph‐node‐first presentation KD are older than those with classic KD …”

Section: Discussionsupporting

confidence: 88%

“…Ultrasound (US) and/or computed tomography (CT) are performed to differentiate cervical lymphadenopathy of other causes such as CL, lymphoma, and abscess in the neck or pharynx, from KD . Cervical US and CT in KD patients have been separately described in several studies, but there are few studies on the radiological differences between KD and CL, partially because most patients with classic KD can be diagnosed from the clinical findings …”

mentioning

confidence: 99%

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Cervical ultrasound and computed tomography of Kawasaki disease: Comparison with lymphadenitis

Nozaki

Morita

Hasegawa

et al. 2016

Pediatrics International

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

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Cervical ultrasound and computed tomography of Kawasaki disease: Comparison with lymphadenitis

Nozaki

Morita

Hasegawa

et al. 2016

Pediatrics International

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“…In the present case, the patient presented with a cellulitis-like rash 5 days before conjunctivitis developed. In a brief review of the published literature, we noted several reports of KD associated with cellulitis in the axilla or the craniocervical region, including the posterior wall of the pharynx, neck, and orbit (1)(2)(3)(4)(5). In those cases, as in the present case, the cellulitis did not respond to antibiotics and no pathogen was isolated.…”

Section: Discussionmentioning

confidence: 99%

Cellulitis‐Like Rash Associated with Kawasaki Disease

Itamura¹,

Ishiguchi²,

Kuwabara³

et al. 2015

Pediatric Dermatology

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We present the case of a 5-year-old-boy who developed a fever and cellulitis-like groin rash 5 days before developing conjunctivitis and 6 to 7 days before other typical signs of Kawasaki disease (KD) appeared. The cellulitis failed to respond to antibiotics and no pathogens were isolated. His fever and clinical signs resolved with intravenous immunoglobulin and high-dose aspirin after discontinuation of antibiotics. Nonbacterial cellulitis is a rare presenting sign of KD, but in the appropriate clinical setting and population, a diagnosis of KD should be considered when cellulitis and fever fail to respond to an appropriate antibiotic regimen and no pathogen can be isolated.

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Pediatric Inflammatory Neck Mass

Hochstim

Messner

2016

Curr Treat Options Peds

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The treatment of pediatric inflammatory neck masses depends upon the underlying etiology and may include both medical and surgical interventions. The most common causes of bacterial cervical lymphadenitis include Staphylococcus aureus (increasingly methicillin-resistant S. aureus), and Streptococcus pyogenes. A contrast-enhanced computed tomography (CT) scan can provide an accurate means of diagnosing whether an abscess is present which might need surgical drainage. Recent studies, however, have focused on the ability to diagnose abscesses using imaging studies that limit the patient exposure to radiation, including the use of ultrasound, magnetic resonance imaging (MRI) and low-voltage CT scanning. Recent database studies have demonstrated trends in the incidence and management of deep neck abscesses from 2000 to 2009. The incidence of retropharyngeal abscesses has increased while the incidence of peritonsillar abscesses, parapharyngeal abscesses or combined space deep neck infections has remained the same. Rates of incision and drainage for retropharyngeal abscesses have decreased, while for peritonsillar abscesses rates of incision and drainage have increased with a corresponding decrease in tonsillectomy rates. Fusobacterial infections have been associated with peritonsillar abscesses and deep neck space infections in association with Lemierre syndrome. These infections are treated with culture-directed antibiotics and surgical drainage when indicated and the prognosis is generally good when identified early. Kawasaki disease (KD) is a potential non-infectious/idiopathic cause of inflammatory pediatric neck mass. In addition to cervical lymphadenopathy, patients with Kawasaki disease may present with retropharyngeal cellulitits or abscess. It is critical that the patient with KD be identified within 10 days of illness onset so the child can be treated with intravenous immunoglobulin which has unequivocally been shown to decrease the incidence of potentially life-threatening cardiac aneurysms.

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Risk factors for retropharyngeal cellulitis in Kawasaki disease

Cited by 22 publications

References 23 publications

Cervical ultrasound and computed tomography of Kawasaki disease: Comparison with lymphadenitis

Cervical ultrasound and computed tomography of Kawasaki disease: Comparison with lymphadenitis

Cellulitis‐Like Rash Associated with Kawasaki Disease

Pediatric Inflammatory Neck Mass

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