Ultrasonographic evaluation of cervical lymph nodes in Kawasaki disease.
OBJECTIVE
Kawasaki disease (KD) is one of the common causes of cervical lymphadenopathy during early childhood. The purpose of this study was to compare the ultrasonographic feature of cervical lymph nodes in patients with KD, bacterial lymphadenitis, and infectious mononucleosis.


METHODS
We studied 22 patients with KD, 8 with presumed bacterial lymphadenitis, and 5 with Epstein-Barr virus infectious mononucleosis. We examined the cervical nodes by ultrasonography using a 7.5-MHz or 10-MHz transducer of a B-mode sector scanner in all patients with a chief complaint of fever and a visible cervical mass during a fixed time interval (July 1995-March 2000).


RESULTS
In KD patients, transverse ultrasonograms demonstrated multiple hypoechoic-enlarged nodes forming one palpable mass, which resembled a cluster of grapes. The ultrasonographic appearance of these nodes was similar in patients with acute Epstein-Barr virus infection, but differed from the pattern in presumed bacterial lymphadenitis. Five KD patients had had fever and cervical lymphadenopathy for several days before other manifestations of KD were noted. In these patients, it was possible to differentiate by ultrasonography between KD and presumed bacterial lymphadenitis at an early stage.


CONCLUSIONS
Ultrasonographic features of cervical lymph nodes were different for KD than for presumed bacterial lymphadenitis. Ultrasonographic evaluation might be of value for diagnosis of KD patients with cervical lymphadenopathy at an early stage of the disease.
Tashiro
Norimichi
N
Department of Pediatrics, Yamaguchi University School of Medicine, Yamaguchi, Japan.
Matsubara
Tomoyo
T
Uchida
Masashi
M
Katayama
Kumiko
K
Ichiyama
Takashi
T
Furukawa
Susumu
S
D001424:Bacterial Infections / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007244:Infectious Mononucleosis / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008199:Lymphadenitis / Q000000981:diagnostic imaging; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000000981:diagnostic imaging*; D009333:Neck / Q000000981:diagnostic imaging; D014463:Ultrasonography