Kawasaki Disease Presenting as Retropharyngeal Cellulitis

Objective: Kawasaki disease (KD), which occurs in infants and children, is an acute multisystemic vasculitis of unknown etiology. Several reports mentioned retropharyngeal cellulitis as a rare manifestation of KD. The purpose of this study is to investigate the population and characteristics of KD manifested by retropharyngeal soft tissue swelling.Method: A retrospective review of 213 patients (mean age of 2 years, age range of 7 months to 10 years) diagnosed as KD between 2005 and 2010.Results: Enhanced computed tomography showed an abnormal low density area without ring enhancement in the retropharyngeal space in 9 cases (4.2%). All of them had fever and cervical lymphadenopathy as the first symptom. Though cervical lymphadenopathy is one of the 6 diagnostic features of KD (fever, skin rash, cervical lymphadenopathy, conjunctivitis, fissuring of lips, and strawberry tongue), the occurrence is reported to be the lowest (about 50%). They were treated by a pediatrician as suppurative lymphadenitis in 6 cas...