Acute peritonsillar swelling: a unique presentation for Kawasaki disease in adolescence.

Authors:
Jae Hong Park
Jae Hong Park
University of Iowa
Iowa City | United States

BMJ Case Rep 2018 Jul 24;2018. Epub 2018 Jul 24.

Women's & Children's Hospital, Adelaide, South Australia, Australia.

We report the case of a 14-year-old man with unilateral peritonsillar swelling, airway compromise and fever. On physical examination, the patient was pyrexic with trismus, dysphonia, uvula deviation, exudative unilateral peritonsillar swelling and unilateral cervical lymphadenopathy. Attempts at aspirating the prominent peritonsillar region were unsuccessful. CT head and neck identified a large inflammatory mass arising from the left palatine tonsil. The patient was treated for presumptive peritonsillar abscess. After failing to respond to intravenous antimicrobials, he progressively developed the classical sequale of Kawasaki's Disease. Echocardiogram identified coronary arteritis. Intravenous immunoglobulin and high-dose aspirin were initiated and his clinical picture improved. Kawasaki's disease mimicking an acute infective process can pose a diagnostic dilemma. It is an uncommon differential in the adolescent population. Prompt recognition and initiation of appropriate therapy are imperative to minimise morbidity.

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2018-224441DOI Listing
July 2018
8 Reads

Publication Analysis

Top Keywords

peritonsillar swelling
12
kawasaki's disease
8
unilateral peritonsillar
8
respond intravenous
4
intravenous antimicrobials
4
failing respond
4
abscess failing
4
peritonsillar abscess
4
antimicrobials progressively
4
progressively developed
4
sequale kawasaki's
4
echocardiogram identified
4
classical sequale
4
presumptive peritonsillar
4
developed classical
4
disease echocardiogram
4
treated presumptive
4
neck identified
4
identified large
4
head neck
4

References

(Supplied by CrossRef)

Sundel et al.
2016
Current recommendations for the pharmacologic therapy in Kawasaki syndrome and management of its cardiovascular complications
De Rosa et al.
Eur Rev Med Pharmacol Sci 2007
“Peritonsillar abscess- an unusual presentation of Kawasaki disease.”
Ravi et al.
J Laryngol Otol 1997

Similar Publications