The Neglected Diagnosis in Retropharyngeal Abnormalities: Kawasaki Disease

Background and Objectives: In patients with Kawasaki disease, retropharyngeal involvements (KDWRPI) is a rare complication. Most reported cases were diagnosed lately because those were often misdiagnosed as bacterial retropharyngeal abscess (BRA). The purpose of this study was to differentiate KDWRPI from BRA in advance. Materials and Methods: We performed a retrospective study comparing children with KDWRPI to those with BRA hospitalized at the university teaching hospital between January 2008 and September 2013. From our retrospectively collected database, we compared clinical, laboratory, and imaging characteristics of KDWRPI and BRA. Results: The study include 11 patients with retropharyngeal involvement on neck computerized tomography (CT) which were divided into two groups. Group A was classified as KDWRPI (n=6) and group B was classified as BRA (n=5). Compared with group B, patients with KDWRPI had lower sodium and albumin (p=0.0176 and 0.0828, respectively). Conclusions: Careful attention to manifestations and close analyses of laboratory findings and CT images may allow otorhinolaryngologists to differentiate KDWRPI from BRA. In the case of retropharyngeal edema on CT, the diagnosis of KDWRPI should not be neglected. (J Clinical Otolaryngol 2017;28:21–218)