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High-frequency Ultrasound Imaging of Mouse Cervical Lymph Nodes
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Imaging and Clinical Data Distinguish Lymphadenopathy-First-Presenting Kawasaki Disease from Bacterial Cervical

Byung Sung Park1, Myung Hoon Bang1, Sung Hye Kim1

  • 1Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.

Journal of Cardiovascular Imaging
|January 5, 2019
PubMed

Insights

Lymphadenopathy-first-presenting Kawasaki disease (LKD) can mimic bacterial cervical lymphadenitis (BCL). Differentiating LKD involves assessing CT for abscesses, patient age, and C-reactive protein (CRP) levels.

Area of Science:

  • Pediatric Infectious Diseases
  • Diagnostic Imaging
  • Rheumatology

Background:

  • Kawasaki disease (KD) can initially present with fever and cervical lymphadenopathy, mimicking bacterial cervical lymphadenitis (BCL).
  • This presentation, termed lymphadenopathy-first-presenting Kawasaki disease (LKD), poses diagnostic challenges.
  • Early differentiation is crucial for appropriate management and preventing complications.

Purpose of the Study:

  • To identify characteristic imaging and clinical features that distinguish LKD from BCL.
  • To compare diagnostic markers between LKD and BCL patients.

Main Methods:

  • A retrospective study comparing imaging, clinical, and laboratory data of patients with LKD, BCL, and typical KD.
  • Inclusion criteria: patients admitted to a single tertiary center between January 2015 and July 2018.
  • Multivariable logistic regression analysis was used to identify independent predictors.

Main Results:

  • Ultrasound showed enlarged lymph nodes in both LKD and BCL; CT revealed more abscesses in BCL.
  • LKD patients were younger and exhibited higher systemic/hepatobiliary inflammatory markers and pyuria than BCL patients.
  • Younger age and elevated C-reactive protein (CRP) were independently associated with LKD. No increased coronary artery abnormalities (CAA) in LKD vs. typical KD.

Conclusions:

  • Absence of CT abscesses, younger age, and elevated CRP are key differentiators for LKD versus BCL.
  • LKD patients show increased systemic inflammation and pyuria compared to BCL.
  • LKD does not confer a higher risk of coronary artery abnormalities compared to typical KD.
Abstract

Keywords:
Bacterial lymphadenitisComputed tomographyCoronary arteryKawasaki disease

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