Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Kawasaki disease presenting as retropharyngeal abscess

후인두부 농양으로 오인된 가와사끼병

  • Cho, Sung Yoon (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Cho, Hye Kyung (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Cho, Ky Young (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Kim, Hae Soon (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Sohn, Sejung (Department of Pediatrics, Ewha Womans University School of Medicine)
  • 조성윤 (이화여자대학교 의학전문대학원 소아과학교실) ;
  • 조혜경 (이화여자대학교 의학전문대학원 소아과학교실) ;
  • 조기영 (이화여자대학교 의학전문대학원 소아과학교실) ;
  • 김혜순 (이화여자대학교 의학전문대학원 소아과학교실) ;
  • 손세정 (이화여자대학교 의학전문대학원 소아과학교실)
  • Received : 2008.05.17
  • Accepted : 2008.08.05
  • Published : 2008.09.15
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Abstract

A group of patients with Kawasaki disease (KD) initially present with cervical lymphadenitis or deep neck infection. These unusual KD presentations lead to unnecessary antibiotic therapy or surgical intervention, thereby delaying intravenous immunoglobulin treatment and increasing the risk of coronary artery damage. We present four KD patients whose initial presentations mimicked a retropharyngeal abscess. Nonsuppurative cervical lymphadenitis or suspected neck abscess unresponsive to intravenous antibiotics could signal the possibility of KD.

가와사끼병은 아직 원인이 밝혀지지 않은 급성 발열성 혈관염으로 진단을 위한 검사 소견이 없기 때문에 진단은 임상적 증상에 의존한다. 초기에 발열과 경부 림프절 종창 소견만을 보이고 가와사끼병의 다른 주 증상은 며칠 후에 서서히 나타나는 경우는 단순히 경부 감염성 질환으로 오인할 수 있다. 저자들은 질병 초기에 CT 검사로 후인두부 농양으로 진단받았으나 항생제 치료에 반응이 없었고 3-4일 후에 가와사끼병의 다른 증상이 뒤늦게 발현되어 정맥면역글로블린 투여 후에 해열과 증상의 호전을 보인 4명의 가와사끼병 환아를 보고하고자 한다. 발열과 림프절 종창의 주 증상으로 인해 경부 림프절염 또는 CT 검사 후 후인두부 농양으로 진단받은 환자들에서 항생제 치료의 효과가 없을 경우에는 가와사끼병의 가능성을 항상 염두에 두어야 한다.

Keywords

References

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