Korean J Pediatr Infect Dis.  2000 May;7(1):152-158. 10.14776/kjpid.2000.7.1.152.

Clinical Characteristics of Lymphadenopathy as the Initial Manifestation of Kawasaki Disease

• Kim JY
• Kim JH
• Moon SC
• Cho BS
• Cha SH

• KMID: 2440236
• DOI: http://doi.org/10.14776/kjpid.2000.7.1.152

Abstract

PURPOSE
Kawasaki disease is an acute illness of unknown cause that affects infants and children. Sometimes, cervical lmphadenitis that seems to be caused by bacterial or viral agents at admission would be changed to Kawasaki disease within several days of hospitalization. Lymphadenopathy is one of major presenting manifestation of both cervical lymphadenitis and Kawasaki disease. We compared Kawasaki disease with cervical lyphadenopathy as the initial manifestation with cervical lymphadenitis without other typical manifestations of Kawasaki disease.
METHODS
We describe and compare the clinical characteristics of 15 patients with Kawasaki disease which were misdiagnosed as cervical lymphadenitis and 125 patients with cervical lymphadenitis, retrospectively.
RESULTS
The clinical characteristics of Kawasaki disease with cervical lymphadenopathy as an initial presenting manifestation were older in age and had more frequent abnormalities in markers of systemic inflammation than kawasaki disease without cervical lymphadenopathy. They would have greater abnormalities in markers of inflammation than cervical lymphadenitis alone. They had higher mean WBC, cESR, CRP which were compared with the patients with cervical lymphadenitis. Usually, patients with cervical lymphadenitis responded to antibiotics promptly, but they did not tend to be responded to antibiotics within 48~72hrs.
CONCLUSION
Patients with Kawasaki disease may initially present with findings that strongly suggest bacterial lymphadenitis with or without other manifestations of Kawasaki disease. If they did not response initial antibiotics administration, they should be closed observed for the possible development of the another signs of Kawasaki disease. Earlier diagnosis of Kawasaki disease can avoid the need for unnecessary procedures and antibiotics and lead to more proper therapy directed at Kawasaki disease.

Keyword

Kawasaki disease; Cervical lymphadenitis; Cervical lymphadenopathy

MeSH Terms

Anti-Bacterial Agents
Child
Diagnosis
Hospitalization
Humans
Infant
Inflammation
Lymphadenitis
Lymphatic Diseases*
Mucocutaneous Lymph Node Syndrome*
Retrospective Studies
Unnecessary Procedures
Anti-Bacterial Agents