title: Recurrent Kawasaki disease in a child with retropharyngeal involvement: a case report and literature review.
abstract: 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.
authors.affiliation: From the Department of Pediatrics, Division of Pediatric Infectious Diseases (BA-K, EC, EI); Department of Ear, Nose, and Throat (MMK); Department of Pediatrics, Division of Pediatric Cardiology (MGR, ET); and Department of Radiology, Faculty of Medicine, Ankara University, Ankara, Turkey (SF).
authors.forename: Bilge
authors.initials: B
authors.lastname: Aldemir-Kocabaş
authors.forename: Mücahit Murat
authors.initials: MM
authors.lastname: Kcal
authors.forename: Mehmet G
authors.initials: MG
authors.lastname: Ramoğlu
authors.forename: Ercan
authors.initials: E
authors.lastname: Tutar
authors.forename: Suat
authors.initials: S
authors.lastname: Fitöz
authors.forename: Ergin
authors.initials: E
authors.lastname: Çiftçi
authors.forename: Erdal
authors.initials: E
authors.lastname: İnce
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002648:Child; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012008:Recurrence; D017703:Retropharyngeal Abscess / Q000209:etiology* / Q000628:therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016756:Immunoglobulins, Intravenous; D001241:Aspirin