Pediatric Infection & Vaccine  2016;23(3):217-222

doi:10.14776/piv.2016.23.3.217

Comparison of Cervical Lymphadenitis as First Presentation of Kawasaki Disease and Acute Unilateral Cervical Lymphadenitis.

Hoon Sang LEE 1 ; Ji Yong KIM ; Bo Kyung SONG ; Yong Woo KIM ; Su Eun PARK

Affiliations

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Keywords

Mucocutaneous lymph node syndrome; Lymphadenitis; Fever; Child

Country

Republic of Korea

Language

Korean

Abstract

PURPOSE: This study aimed to identify the differential clinical, laboratory, and imaging characteristics between patients with cervical lymphadenitis as first presentation of Kawasaki disease (CLKD) and those with acute unilateral cervical lymphadenitis (AUCL). METHODS: We surveyed 372 patients who visited Pusan National University Children's Hospital because of fever and cervical lymph node enlargement, and underwent neck computed tomography (CT) from January 2010 to December 2014. We compared 28 confirmed cases of Kawasaki disease and 28 cases of AUCL based on a retrospective review of the medical records of the patients. RESULTS: Patients with CLKD and AUCL showed no differential clinical characteristics in terms of the duration of fever, antibiotic use, or the size of lymph nodes. Patients with CLKD had higher white blood cell count, absolute neutrophil count, erythrocyte sedimentation rate, and C-reactive protein levels (P<0.05) than those of patients with AUCL. The presence of retropharyngeal edema on neck CT was similar between the groups (64% vs. 33%, P=0.686). CONCLUSIONS: CLKD and AUCL showed no differentiating clinical and radiological characteristics; hence, Kawasaki disease should be the presumptive diagnosis in patients with fever and cervical lymph node enlargements who fail to respond to antibiotic treatment.