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A case of Kawasaki disease presenting with parotitis: A case report and literature review.
Medicine (Baltimore). 2019 May; 98(22):e15817.M

Abstract

RATIONALE

Kawasaki disease affects multiple organ systems. Its typical symptoms include fever, rash, oropharyngeal mucosal erythema, bilateral non-exudative conjunctivitis, cervical lymphadenopathy, extremity changes, and membranous desquamation of the fingers and toes. In severe cases, cardiovascular, respiratory, musculoskeletal, gastrointestinal, neurological, and genitourinary complications may occur. In the early stage, Kawasaki disease is often manifested by uncommon symptoms, such as pyuria, meningitis, shock, and retropharyngeal or parapharyngeal abscess, which may delay diagnosis and treatment. We have reported a case of Kawasaki disease presenting with mumps and reviewed the clinical features of 14 other similar cases, in order to facilitate the early diagnosis and treatment of this unusual presentation of Kawasaki disease.

PATIENT CONCERNS

A 10-year-old boy presented with persistent fever and parotitis and was diagnosed with suppurative parotitis. After antibiotic therapy, the parotid swelling reduced, but the fever persisted and other typical symptoms of Kawasaki disease appeared, including bilateral conjunctival hyperaemia, cervical lymphadenopathy, oropharyngeal mucosal erythema, membranous desquamation of the fingers, and left coronary artery widening.

DIAGNOSES

The patient was diagnosed with Kawasaki disease 12 days after the onset of fever.

INTERVENTIONS

The patient was administered γ-globulin 1.0 g/kg·d for 2 consecutive days and oral aspirin 5 mg/kg·d.

OUTCOMES

The left coronary artery returned to a width of 3.8 mm after 1 month and of 3.1 mm after 3 months. The dose of aspirin was reduced to 3 mg/kg·d after 2 months and to 1.5 mg/kg·d after 3 months.

LESSONS

Physicians should be aware that Kawasaki disease may develop after parotitis.

Authors+Show Affiliations

Department of Pediatric Respiratory Medicine, The First Hospital of Jilin University, Changchun, Jilin Province, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31145317

Citation

Li, Yanchun, et al. "A Case of Kawasaki Disease Presenting With Parotitis: a Case Report and Literature Review." Medicine, vol. 98, no. 22, 2019, pp. e15817.
Li Y, Yang Q, Yu X, et al. A case of Kawasaki disease presenting with parotitis: A case report and literature review. Medicine (Baltimore). 2019;98(22):e15817.
Li, Y., Yang, Q., Yu, X., & Qiao, H. (2019). A case of Kawasaki disease presenting with parotitis: A case report and literature review. Medicine, 98(22), e15817. https://doi.org/10.1097/MD.0000000000015817
Li Y, et al. A Case of Kawasaki Disease Presenting With Parotitis: a Case Report and Literature Review. Medicine (Baltimore). 2019;98(22):e15817. PubMed PMID: 31145317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case of Kawasaki disease presenting with parotitis: A case report and literature review. AU - Li,Yanchun, AU - Yang,Qingran, AU - Yu,Xiuhua, AU - Qiao,Hongmei, PY - 2019/5/31/entrez PY - 2019/5/31/pubmed PY - 2019/6/14/medline SP - e15817 EP - e15817 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 22 N2 - RATIONALE: Kawasaki disease affects multiple organ systems. Its typical symptoms include fever, rash, oropharyngeal mucosal erythema, bilateral non-exudative conjunctivitis, cervical lymphadenopathy, extremity changes, and membranous desquamation of the fingers and toes. In severe cases, cardiovascular, respiratory, musculoskeletal, gastrointestinal, neurological, and genitourinary complications may occur. In the early stage, Kawasaki disease is often manifested by uncommon symptoms, such as pyuria, meningitis, shock, and retropharyngeal or parapharyngeal abscess, which may delay diagnosis and treatment. We have reported a case of Kawasaki disease presenting with mumps and reviewed the clinical features of 14 other similar cases, in order to facilitate the early diagnosis and treatment of this unusual presentation of Kawasaki disease. PATIENT CONCERNS: A 10-year-old boy presented with persistent fever and parotitis and was diagnosed with suppurative parotitis. After antibiotic therapy, the parotid swelling reduced, but the fever persisted and other typical symptoms of Kawasaki disease appeared, including bilateral conjunctival hyperaemia, cervical lymphadenopathy, oropharyngeal mucosal erythema, membranous desquamation of the fingers, and left coronary artery widening. DIAGNOSES: The patient was diagnosed with Kawasaki disease 12 days after the onset of fever. INTERVENTIONS: The patient was administered γ-globulin 1.0 g/kg·d for 2 consecutive days and oral aspirin 5 mg/kg·d. OUTCOMES: The left coronary artery returned to a width of 3.8 mm after 1 month and of 3.1 mm after 3 months. The dose of aspirin was reduced to 3 mg/kg·d after 2 months and to 1.5 mg/kg·d after 3 months. LESSONS: Physicians should be aware that Kawasaki disease may develop after parotitis. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31145317/A_case_of_Kawasaki_disease_presenting_with_parotitis:_A_case_report_and_literature_review_ L2 - http://dx.doi.org/10.1097/MD.0000000000015817 DB - PRIME DP - Unbound Medicine ER -