CASE REPORT
Infantile cervical adenopathy and pyrexia with an unexpected sequel
 
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1
Department of Otorhinolaryngology – Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
 
2
Department of Otorhinolaryngology – Head and Neck Surgery, Hospital Putrajaya, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia
 
 
Submission date: 2017-06-16
 
 
Acceptance date: 2017-09-20
 
 
Online publication date: 2019-11-25
 
 
Corresponding author
Jeyasakthy Saniasiaya   

Department of Otorhinolaryngology – Head and Neck Surgery, School of Medical Scinces, Universiti Sains Malaysia, Health campus, 16150 Kota Bharu, Kelantan, Malaysia. Tel.: +6097673000.
 
 
Pol. Ann. Med. 2019;26(2):151-154
 
KEYWORDS
ABSTRACT
Introduction:
Clinical presentation of cervical adenopathy and fever among infants albeit common remains a conundrum to many physicians notably, the otorhinolaryngologists. Kawasaki disease (KD) is an acute febrile systemic vasculitis which oftentimes is associated with cervical adenopathy.

Aim:
We would like to highlight the diagnostic challenges faced along with management of KD and the importance of awareness amongst physicians in diagnosing this entity early.

Case study:
Herein, we are reporting a case of a 10-month old who initially presented with a 3-day history of fever and unilateral cervical lymphadenopathy.

Results and discussion:
This later turned out to be KD as the child progressively developed late onset of rashes, erythema of lips and tongue and edema of the hands and feet. Child successfully recovered with intravenous immunoglobulin and oral aspirin with no fatal complications.

Conclusions:
Infants with fever and cervical adenopathy should not be taken frivolously as it may be a red herring of a more gruelling condition. As in our case, it turned out to be KD. Thus, high index of suspicion and collaboration between clinicians are prudent for early and accurate diagnosis and management as early treatment has been proven to improve the prognosis of patients.

FUNDING
All authors declare no financial support.
CONFLICT OF INTEREST
There is no conflict of interest.
REFERENCES (16)
1.
Al Saleh A. Kawasaki disease: a case report. IJCMR. 2016;3(6):1809–1810.
 
2.
Bhatnagar SK, Paul G, Subramaniam R, Al Hosni MS, Al Khusaiby SM. Kawasaki disease in Oman-a clinical study. J Trop Pediatr. 2003;49(6):361–366. https://doi.org/10.1093/tropej....
 
3.
Laupland KB, Dele Davis H. Epidemiology, etiology and management of Kawasaki disease: state of art. Pediatr Cardiol. 1999;20(23):177–183. https://doi.org/10.1007/s00246....
 
4.
Akhter A, Setu M, Ahmed MU, Amin SK, Islam MN, Morshed SMN. Kawasaki disease-A case report. AKMMC J. 2015;6(1):42–45.
 
5.
Burns JC, Glode MP. Kawasaki syndrome. Lancet. 2004;364(9433):533–544. https://doi.org/10.1016/S0140-....
 
6.
Burns JC, Kushner HI, Bastian JF, et al. Kawasaki disease: A brief history. Pediatrics. 2000;106(2):127. https://doi.org/10.1542/peds.1....
 
7.
Leonardi S, Miraglia del Gludice M, La Rosa M, Bellanti JA. Atopic disease, immune system and environment. Allergy Asthma Proc. 2007;28(4):410–417. https://doi.org/10.2500/aap.20....
 
8.
Kara A, Tezer H, Devrim I, et al. Kawasaki disease: A case report in extreme paediatrics. IDCP. 2006;14(5):333–334. https://doi.org/10.1097/01.idc....
 
9.
American Heart Association. Diagnostic guidelines for Kawasaki disease. Am J Dis Child. 1990;144(11):1218–1219. https://doi.org/10.1097/10.100....
 
10.
Shah P, Sen M, Michie CA. Incomplete Kawasaki disease. Lessons to be learned. J Ped Infect Dis. 2008;3:79–81.
 
11.
De Castro PA, Urbano LM, Costa IM. [Kawasaki disease]. An Bras Dermatol. 2009;84:1–14 [in Portuguese]. http://dx.doi.org/10.1590/S036....
 
12.
Burns JC, Shike H, Gordon JB, Malhotra A, Schoenwetter M, Kawasaki T. Sequelae of Kawasaki disease in adolescents and young adults. J Am Coll Cardiol. 1996;28(1):1141–1148. https://doi.org/10.1016/0735-1....
 
13.
Pemberton MN, Doughty IM, Middlehurst RJ, Thornhill MH. Recurrent Kawasaki disease. Br Dent J. 1999;186(6):270–271. https://doi.org/10.1038/sj.bdj....
 
14.
Friedman AM. Evaluation and management of lymphadenopathy in children. Pediatr Review. 2008;29(2):53–59. https://doi.org/10.1542/pir.29....
 
15.
Parmar R, Somale A, Bavdekar S, et al. Incomplete Kawasaki disease with recurrent skin peeling: a case report with the review of literature. J Postgrad Med. 2003;49(1):72. https://doi.org/10.4103/0022-3....
 
16.
Yanagawa H, Nakamura Y, Yashiro M, et al. Results of 12 nationwide surveys of Kawasaki disease. In: Kato H, ed. Kawasaki Disease. Amsterdam: Elsevier Science. 1995;3–14.
 
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