title: Risk factors for retropharyngeal cellulitis in Kawasaki disease.
abstract: OBJECTIVE
  Kawasaki disease (KD) is an acute multisystemic vasculitis of unknown etiology that occurs in infants and children. Retropharyngeal cellulitis has been reported as a rare manifestation of KD. This study investigated the frequency and characteristics of patients with KD manifesting as retropharyngeal soft-tissue swelling.
  
  
  METHODS
  We retrospectively reviewed 277 patients, with a mean age of 1 year and an age range of 7 months to 12 years, in whom KD had been diagnosed between 2005 and 2011.
  
  
  RESULTS
  In 10 patients (3.6%), contrast-enhanced computed tomography (CECT) showed low-density lesions without ring enhancement in the retropharyngeal spaces. These patients presented initially with fever and cervical lymphadenopathy, and were initially treated by their pediatricians for suppurative lymphadenitis (seven patients) or retropharyngeal abscess (three patients). KD was finally diagnosed either after antibiotics had been ineffective or when other symptoms characteristic of KD emerged.
  
  
  CONCLUSIONS
  Low-density lesions in the retropharyngeal space were identified by CECT in 3.6% of the KD patients. Early diagnosis of KD is essential because coronary artery lesions develop in 50% of untreated patients. If a child presents with fever, cervical lymphadenopathy, and swelling of the retropharyngeal space, KD should be included in the differential diagnoses.
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan; Department of Otolaryngology, Institute of Biomedical Research and Innovation, Japan. Electronic address: kurihara@fbri.org.
authors: Risa
authors: R
authors: Tona
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan.
authors: Shogo
authors: S
authors: Shinohara
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan.
authors: Keizo
authors: K
authors: Fujiwara
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan.
authors: Masahiro
authors: M
authors: Kikuchi
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan.
authors: Yuji
authors: Y
authors: Kanazawa
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan.
authors: Ippei
authors: I
authors: Kishimoto
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan.
authors: Hiroyuki
authors: H
authors: Harada
authors: Department of Otolaryngology, Kobe City Medical Center General Hospital, Japan; Department of Otolaryngology, Institute of Biomedical Research and Innovation, Japan.
authors: Yasushi
authors: Y
authors: Naito
mesh_terms: D000367:Age Factors; D002481:Cellulitis / Q000000981:diagnostic imaging* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004487:Edema / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D009333:Neck; D010608:Pharyngeal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D010614:Pharynx; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: Child; Kawasaki disease; Mucocutaneous lymph-node syndrome; Retropharyngeal cellulitis