Recurrent Kawasaki disease in a child with retropharyngeal involvement: a case report and literature review

Kawasaki disease (KD) is a multisystemic vasculitic disease. Recurrent KD is rare and generally presents in a similar clinical picture as the first episode, and early diagnosis with prompt treatment is the key point in preventing associated cardiovascular morbidities. A 9-year-old boy, who was diagn...

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Veröffentlicht in:Medicine (Baltimore) 2014-12, Vol.93 (29), p.e139-e139
Hauptverfasser: Aldemir-Kocabaş, Bilge, Kcal, Mücahit Murat, Ramoğlu, Mehmet G, Tutar, Ercan, Fitöz, Suat, Çiftçi, Ergin, İnce, Erdal
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container_end_page e139
container_issue 29
container_start_page e139
container_title Medicine (Baltimore)
container_volume 93
creator Aldemir-Kocabaş, Bilge
Kcal, Mücahit Murat
Ramoğlu, Mehmet G
Tutar, Ercan
Fitöz, Suat
Çiftçi, Ergin
İnce, Erdal
description Kawasaki disease (KD) is a multisystemic vasculitic disease. Recurrent KD is rare and generally presents in a similar clinical picture as the first episode, and early diagnosis with prompt treatment is the key point in preventing associated cardiovascular morbidities. A 9-year-old boy, who was diagnosed with KD when he was 1.5 years' old, was referred to our hospital for surgical drainage of retropharyngeal abscess. He had a 7-day history of high fever, sore throat, left-sided neck swelling, and restricted neck movements. Subsequently, he was diagnosed with recurrent KD and retropharyngeal involvement. He was successfully treated with a single dose of intravenous immunoglobulin (IVIG) and acetyl salicylic acid. Recurrence is rare and occurs most commonly in children. Atypical presentation, incomplete disease, short duration of fever, and reduced response to IVIG treatment were found to be the risk factors for recurrence. KD can occasionally present with clinical and radiographic findings of deep neck bacterial infection. Unusual presentations in KD may cause delay in diagnosis and increase the risk of life-threatening complications. We describe a case of recurrent KD presenting with a clinical picture resembling retropharyngeal infection who fully recovered after 1 dose of IVIG instead of surgical drainage and antibiotic use.
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Recurrent KD is rare and generally presents in a similar clinical picture as the first episode, and early diagnosis with prompt treatment is the key point in preventing associated cardiovascular morbidities. A 9-year-old boy, who was diagnosed with KD when he was 1.5 years' old, was referred to our hospital for surgical drainage of retropharyngeal abscess. He had a 7-day history of high fever, sore throat, left-sided neck swelling, and restricted neck movements. Subsequently, he was diagnosed with recurrent KD and retropharyngeal involvement. He was successfully treated with a single dose of intravenous immunoglobulin (IVIG) and acetyl salicylic acid. Recurrence is rare and occurs most commonly in children. Atypical presentation, incomplete disease, short duration of fever, and reduced response to IVIG treatment were found to be the risk factors for recurrence. KD can occasionally present with clinical and radiographic findings of deep neck bacterial infection. Unusual presentations in KD may cause delay in diagnosis and increase the risk of life-threatening complications. 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subjects Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Aspirin - therapeutic use
Child
Clinical Case Report
Humans
Immunoglobulins, Intravenous - therapeutic use
Male
Mucocutaneous Lymph Node Syndrome - complications
Mucocutaneous Lymph Node Syndrome - diagnosis
Mucocutaneous Lymph Node Syndrome - drug therapy
Recurrence
Retropharyngeal Abscess - etiology
Retropharyngeal Abscess - therapy
title Recurrent Kawasaki disease in a child with retropharyngeal involvement: a case report and literature review
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