An atypical presentation of Kawasaki disease resembling a retropharyngeal abscess

Kawasaki disease is an acute systemic inflammatory disease, which occurs in children less than 10 years of age. The etiology of the disorder is unknown. Diagnosis is based upon clinician's recognition of a symptom pattern that includes high fevers, oral cavity changes, polymorphous rash, conjunctival injection, and cervical adenopathy. Most feared are the cardiac manifestations of Kawasaki syndrome, which result in an overall mortality rate of 2% in patients. Because of the common presenting symptoms, the otolaryngologist often plays a central role in early diagnosis of the disorder. The following case report describes a patient with Kawasaki disease whose initial presentation mimicked a retropharyngeal abscess. A literature review details the common and atypical early signs and symptoms of Kawasaki disease. (C) 2000 Elsevier Science Ireland Ltd.