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Kawasaki Disease and Cervical Adenopathy

Kawasaki Disease and Cervical Adenopathy Abstract • Kawasaki disease (KD) is an acute illness of unknown cause that affects infants and children. The diagnosis is confirmed in patients with prolonged fever and four of the following clinical features: (1) nonexudative conjunctivitis; (2) oral cavity changes; (3) rash; (4) extremity changes; and (5) cervical adenopathy. Complications of KD include coronary artery aneurysms, which may lead to myocardial infarction, chronic coronary insufficiency, or death. We describe a series of 83 patients with KD in whom 43 (52%) of 83 developed cervical adenopathy during their acute illness. Eighteen (42%) of these 43 patients were initially misdiagnosed as having cervical adenitis and were treated with antibiotics. The otolaryngologist may see these patients in referral and should consider the diagnosis of KD in patients with cervical adenopathy, prolonged fever, signs of mucosal inflammation, or rash. Early diagnosis and intravenous treatment with high-dose γ-globulin is effective in reducing the prevalence of coronary artery abnormalities. (Arch Otolaryngol Head Neck Surg 1989;115:512-514) References 1. Kawasaki T: Acute febrile lymph node syndrome: Clinical observations of 50 cases . Jpn J Allergy 1967;16:178-222 (in Japanese). 2. Kato H, Koike S, Yokoyama T: Kawasaki disease: Effect of treatment on coronary artery involvement . Pediatrics 1979;63:175-179. 3. Yanagawa H, Kawasaki T, Shigematsu I: Nationwide survey on Kawasaki disease in Japan . Pediatrics 1987;80:58-62. 4. Bell DM, Morens DM, Holman RC, et al: Kawasaki syndrome in the United States . AJDC 1983;137:211-214. 5. Burns JC, Joffe L, Sargent RA, et al: Anterior uveitis in Kawasaki syndrome . Pediatr Infect Dis 1985;4:258-261.Crossref 6. Geisker DW, Krause PJ, Pastuszak WT, et al: Lymph node biopsy for early diagnosis in Kawasaki disease . Am J Surg Pathol 1982;6:493-501.Crossref 7. Kato H, Ichinose E, Yoshioka F, et al: Fate of coronary aneurysms in Kawasaki disease: Serial coronary angiography and long-term follow up study . Am J Cardiol 1982;49:1758-1766.Crossref 8. Newburger JW, Takahashi M, Burns JC, et al: Treatment of Kawasaki syndrome with intravenous gamma globulin . N Engl J Med 1986; 315:341-347.Crossref 9. Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III lymphadenopathy-associated virus infection . MMWR 1986; 35:231-233. 10. Yanagihara R, Todd JK: Acute febrile mucocutaneous lymph node syndrome . AJDC 1980;134:603-614. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1989.01860280110027
Publisher site
See Article on Publisher Site

Abstract

Abstract • Kawasaki disease (KD) is an acute illness of unknown cause that affects infants and children. The diagnosis is confirmed in patients with prolonged fever and four of the following clinical features: (1) nonexudative conjunctivitis; (2) oral cavity changes; (3) rash; (4) extremity changes; and (5) cervical adenopathy. Complications of KD include coronary artery aneurysms, which may lead to myocardial infarction, chronic coronary insufficiency, or death. We describe a series of 83 patients with KD in whom 43 (52%) of 83 developed cervical adenopathy during their acute illness. Eighteen (42%) of these 43 patients were initially misdiagnosed as having cervical adenitis and were treated with antibiotics. The otolaryngologist may see these patients in referral and should consider the diagnosis of KD in patients with cervical adenopathy, prolonged fever, signs of mucosal inflammation, or rash. Early diagnosis and intravenous treatment with high-dose γ-globulin is effective in reducing the prevalence of coronary artery abnormalities. (Arch Otolaryngol Head Neck Surg 1989;115:512-514) References 1. Kawasaki T: Acute febrile lymph node syndrome: Clinical observations of 50 cases . Jpn J Allergy 1967;16:178-222 (in Japanese). 2. Kato H, Koike S, Yokoyama T: Kawasaki disease: Effect of treatment on coronary artery involvement . Pediatrics 1979;63:175-179. 3. Yanagawa H, Kawasaki T, Shigematsu I: Nationwide survey on Kawasaki disease in Japan . Pediatrics 1987;80:58-62. 4. Bell DM, Morens DM, Holman RC, et al: Kawasaki syndrome in the United States . AJDC 1983;137:211-214. 5. Burns JC, Joffe L, Sargent RA, et al: Anterior uveitis in Kawasaki syndrome . Pediatr Infect Dis 1985;4:258-261.Crossref 6. Geisker DW, Krause PJ, Pastuszak WT, et al: Lymph node biopsy for early diagnosis in Kawasaki disease . Am J Surg Pathol 1982;6:493-501.Crossref 7. Kato H, Ichinose E, Yoshioka F, et al: Fate of coronary aneurysms in Kawasaki disease: Serial coronary angiography and long-term follow up study . Am J Cardiol 1982;49:1758-1766.Crossref 8. Newburger JW, Takahashi M, Burns JC, et al: Treatment of Kawasaki syndrome with intravenous gamma globulin . N Engl J Med 1986; 315:341-347.Crossref 9. Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III lymphadenopathy-associated virus infection . MMWR 1986; 35:231-233. 10. Yanagihara R, Todd JK: Acute febrile mucocutaneous lymph node syndrome . AJDC 1980;134:603-614.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Apr 1, 1989

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