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Abstract：
OBJECTIVE: Kawasaki Disease (KD) may mimic Parapharyngeal (PPI) and Retropharyngeal Infections (RPI), leading to misdiagnosis as Deep Neck Infections (DNIs). The treatment plans for the two diseases are different, and delayed treatment can lead to serious complications. Therefore, prompt diagnosis and management are necessary. This study was performed to evaluate the clinical features of KD mimicking DNIs and explore the treatment options.
METHODS: Children with cellulitis or abscess in parapharyngeal or retropharyngeal space in neck CT were included in this study. The medical records of enrolled children were retrospectively reviewed.
RESULTS: In total, 56 children were diagnosed with PPI or/and RPI. Twenty-two (39.3%) participants were eventually diagnosed with KD, and 34 (60.7%) were diagnosed with DNIs. Compared with the DNIs group, the KD group had a higher body temperature (p=0.007), and higher levels of AST (p=0.040), ALT (p=0.027), and ESR (p=0.030). Deep cervical cellulitis (p=0.005) were more common in the KD group. However, deep neck abscess often occurred in the DNIs group (p=0.002), with parapharyngeal abscess being the most common type of abscess (p=0.004). The KD mimicking DNIs cases did not respond to antibiotic treatment, but symptoms significantly improved after the use of Immunoglobulin (IVIG) and aspirin.
CONCLUSIONS: Children with KD may exhibit retropharyngeal or parapharyngeal inflammation in the early stages. KD should be considered a differential diagnosis for children with DNIs, high fever, and no response to antibiotic therapy. Surgery in KD mimicking deep neck abscess requires caution.
METHODS: I.
METHODS: Children with cellulitis or abscess in parapharyngeal or retropharyngeal space in neck CT were included in this study. The medical records of enrolled children were retrospectively reviewed.
RESULTS: In total, 56 children were diagnosed with PPI or/and RPI. Twenty-two (39.3%) participants were eventually diagnosed with KD, and 34 (60.7%) were diagnosed with DNIs. Compared with the DNIs group, the KD group had a higher body temperature (p=0.007), and higher levels of AST (p=0.040), ALT (p=0.027), and ESR (p=0.030). Deep cervical cellulitis (p=0.005) were more common in the KD group. However, deep neck abscess often occurred in the DNIs group (p=0.002), with parapharyngeal abscess being the most common type of abscess (p=0.004). The KD mimicking DNIs cases did not respond to antibiotic treatment, but symptoms significantly improved after the use of Immunoglobulin (IVIG) and aspirin.
CONCLUSIONS: Children with KD may exhibit retropharyngeal or parapharyngeal inflammation in the early stages. KD should be considered a differential diagnosis for children with DNIs, high fever, and no response to antibiotic therapy. Surgery in KD mimicking deep neck abscess requires caution.
METHODS: I.
摘要：
目的：川崎病（KD）可能模拟咽旁炎（PPI）和咽后感染（RPI），导致误诊为颈深感染（DNIs）。两种疾病的治疗方案不同，延迟治疗会导致严重的并发症。因此,及时的诊断和管理是必要的。进行这项研究以评估模拟DNIs的KD的临床特征并探索治疗方案。
方法：本研究包括颈部CT表现为咽旁间隙或咽后间隙蜂窝织炎或脓肿的儿童。对登记儿童的医疗记录进行回顾性审查。
结果：总计，56名儿童被诊断为PPI或/和RPI。22名（39.3%）参与者最终被诊断为KD，34例（60.7%）被诊断为DNIs。与DNIs组相比，KD组体温较高(p=0.007)，和更高水平的AST(p=0.040)，ALT（p=0.027），和ESR(p=0.030)。深宫颈蜂窝织炎（p=0.005）在KD组中更为常见。然而,深颈部脓肿常发生在DNIs组（p=0.002），咽旁脓肿是最常见的脓肿类型（p=0.004）。模拟DNIs的KD病例对抗生素治疗没有反应，但使用免疫球蛋白（IVIG）和阿司匹林后症状显着改善。
结论：KD患儿早期可能出现咽后或咽旁炎。KD应被视为儿童DNIs的鉴别诊断，高烧,对抗生素治疗没有反应。模拟颈深部脓肿的KD手术需要谨慎。
方法：I.
方法：本研究包括颈部CT表现为咽旁间隙或咽后间隙蜂窝织炎或脓肿的儿童。对登记儿童的医疗记录进行回顾性审查。
结果：总计，56名儿童被诊断为PPI或/和RPI。22名（39.3%）参与者最终被诊断为KD，34例（60.7%）被诊断为DNIs。与DNIs组相比，KD组体温较高(p=0.007)，和更高水平的AST(p=0.040)，ALT（p=0.027），和ESR(p=0.030)。深宫颈蜂窝织炎（p=0.005）在KD组中更为常见。然而,深颈部脓肿常发生在DNIs组（p=0.002），咽旁脓肿是最常见的脓肿类型（p=0.004）。模拟DNIs的KD病例对抗生素治疗没有反应，但使用免疫球蛋白（IVIG）和阿司匹林后症状显着改善。
结论：KD患儿早期可能出现咽后或咽旁炎。KD应被视为儿童DNIs的鉴别诊断，高烧,对抗生素治疗没有反应。模拟颈深部脓肿的KD手术需要谨慎。
方法：I.
