Tags

Type your tag names separated by a space and hit enter

Extensive cervical lymphadenitis mimicking bacterial adenitis as the first presentation of Kawasaki disease.
Einstein (Sao Paulo). 2015 Jul-Sep; 13(3):426-9.E

Abstract

Cervical adenitis >1.5cm in diameter is the less frequently observed criteria in patients with Kawasaki disease and it is usually found in association with other symptoms during the acute phase. Moreover, the finding of fever and lymphadenitis with intense local signs of inflammation and phlegmon is rarely seen as the initial manifestation of Kawasaki disease. We report the case of a 7-year-old boy who had cervical lymphadenitis with adjacent cellulitis and phlegmon mimicking bacterial adenitis as the first presentation of Kawasaki disease. The patient had fever, cervical lymphadenitis with adjacent cellulitis, and severe headache. Cefadroxil was prescribed based on the clinical diagnosis of bacterial adenitis. Because he remained febrile and phlogistic signs worsened, after 1 day of hospitalization, antibiotics were administrated intravenously (ceftriaxone and oxacillin). The computed tomography of the neck showed primary infectious/inflammatory process. On the fourth day, the patient had dry and scaly lips, and treatment with oxacillin was replaced by clindamycin because the patient was still febrile. On the ninth day, he presented non-exudative bilateral conjunctival injection. On the tenth day of febrile disease, a rash appeared on his trunk, hands and feet. Patient's symptoms resolved after intravenous administration of immunoglobulin (2g/kg/dose), and he was discharged 2 days later. On the 14th day, the patient had lamellar desquamation of fingers. Kawasaki disease should be considered as a differential diagnosis in children with febrile cervical lymphadenitis unresponsive to empiric antibiotics even if they have adjacent cellulitis and phlegmon.

Authors+Show Affiliations

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Pub Type(s)

Case Reports
Journal Article

Language

eng por

PubMed ID

26132362

Citation

Rossi, Felipe de Souza, et al. "Extensive Cervical Lymphadenitis Mimicking Bacterial Adenitis as the First Presentation of Kawasaki Disease." Einstein (Sao Paulo, Brazil), vol. 13, no. 3, 2015, pp. 426-9.
Rossi Fde S, Silva MF, Kozu KT, et al. Extensive cervical lymphadenitis mimicking bacterial adenitis as the first presentation of Kawasaki disease. Einstein (Sao Paulo). 2015;13(3):426-9.
Rossi, F. d. e. . S., Silva, M. F., Kozu, K. T., Camargo, L. F., Rossi, F. F., Silva, C. A., & Campos, L. M. (2015). Extensive cervical lymphadenitis mimicking bacterial adenitis as the first presentation of Kawasaki disease. Einstein (Sao Paulo, Brazil), 13(3), 426-9. https://doi.org/10.1590/S1679-45082015RC2987
Rossi Fde S, et al. Extensive Cervical Lymphadenitis Mimicking Bacterial Adenitis as the First Presentation of Kawasaki Disease. Einstein (Sao Paulo). 2015 Jul-Sep;13(3):426-9. PubMed PMID: 26132362.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extensive cervical lymphadenitis mimicking bacterial adenitis as the first presentation of Kawasaki disease. AU - Rossi,Felipe de Souza, AU - Silva,Marco Felipe Castro da, AU - Kozu,Kátia Tomie, AU - Camargo,Luís Fernando Aranha, AU - Rossi,Flávia Feijó Panico, AU - Silva,Clovis Artur, AU - Campos,Lúcia Maria de Arruda, Y1 - 2015/06/30/ PY - 2013/09/27/received PY - 2014/08/29/accepted PY - 2015/7/2/entrez PY - 2015/7/2/pubmed PY - 2016/3/12/medline SP - 426 EP - 9 JF - Einstein (Sao Paulo, Brazil) JO - Einstein (Sao Paulo) VL - 13 IS - 3 N2 - Cervical adenitis >1.5cm in diameter is the less frequently observed criteria in patients with Kawasaki disease and it is usually found in association with other symptoms during the acute phase. Moreover, the finding of fever and lymphadenitis with intense local signs of inflammation and phlegmon is rarely seen as the initial manifestation of Kawasaki disease. We report the case of a 7-year-old boy who had cervical lymphadenitis with adjacent cellulitis and phlegmon mimicking bacterial adenitis as the first presentation of Kawasaki disease. The patient had fever, cervical lymphadenitis with adjacent cellulitis, and severe headache. Cefadroxil was prescribed based on the clinical diagnosis of bacterial adenitis. Because he remained febrile and phlogistic signs worsened, after 1 day of hospitalization, antibiotics were administrated intravenously (ceftriaxone and oxacillin). The computed tomography of the neck showed primary infectious/inflammatory process. On the fourth day, the patient had dry and scaly lips, and treatment with oxacillin was replaced by clindamycin because the patient was still febrile. On the ninth day, he presented non-exudative bilateral conjunctival injection. On the tenth day of febrile disease, a rash appeared on his trunk, hands and feet. Patient's symptoms resolved after intravenous administration of immunoglobulin (2g/kg/dose), and he was discharged 2 days later. On the 14th day, the patient had lamellar desquamation of fingers. Kawasaki disease should be considered as a differential diagnosis in children with febrile cervical lymphadenitis unresponsive to empiric antibiotics even if they have adjacent cellulitis and phlegmon. SN - 2317-6385 UR - https://www.unboundmedicine.com/medline/citation/26132362/Extensive_cervical_lymphadenitis_mimicking_bacterial_adenitis_as_the_first_presentation_of_Kawasaki_disease_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015005052987&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -