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.
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.