We report a case of Kawasaki disease mimicking a retropharyngeal abscess. A boy aged 7 years and 11 months was hospitalized after 4 days with a high fever and cervical lymphadenopathy. Contrast-enhanced head and neck computed tomography (CT) showed a low-density lesion in the posterior pharyngeal space. Having all 6 clinical criteria for Kawasaki disease on hospital day 2, the boy was treated with γ-globulin, ibuprofen, and antibiotics, which gradually alleviated all clinical signs. An abscess-like retropharyngeal lesion is considered a manifestation of Kawasaki disease. Cervical lymphadenopathy is the presenting symptom in only 12% of subjects with Kawasaki disease, and may significantly delay diagnosis. It is therefore important when examining a child with a retropharyngeal abscess to consider the possibility of Kawasaki disease.
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