Retropharyngeal abscess: An unusual presentation of Kawasaki disease. Case report and review of the literature

We report the case of a patient with Kawasaki disease whose initial presentation mimicked a retropharyngeal abscess and review the literature of this topic (16 cases reported). Fever and deep neck infection like symptoms were the only clinical findings at admission in 87.5% children. All children had a neck CT scan performed showing findings suggestive of retropharyngeal abscess. All children were started antibiotic therapy without clinical improvement and 31% of patients underwent unproductive surgical drainage of the retropharyngeal space. Otolaryngologist should be aware of atypical presentation of Kawasaki disease presentation mimicking retropharyngeal abscess. Early diagnosis is pivotal for preventing cardiac complications and avoiding the risk associated to unnecessary surgical intervention.