Parotitis as an initial symptom of kawasaki disease - Case R
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A 13-month-old boy was admitted to our hospital with a 3-day history of fever and right side enlarged parotid gland. There was no recent history of travel, contact with sick individuals, or exposure to pets. He had not been vaccinated against mumps. Physical examination revealed a body temperature of 39.5°C and a respiratory rate of 48 breaths per minute. A painful, erythematous, warm hard mass measuring 2 × 4 cm was identified between the area posterior to the right ear and the area inferior to the jaw. An enhanced computed tomography scan of the pharynx revealed increased intensity in the right parotid grand, and the adjacent lymph nodes were enlarged. The patient received ampicillin/sulbactam and clindamycin for 2 days to treat presumed suppurative parotitis. On the 5th day of illness, he developed lip redness, conjunctival injection, reddening of the BCG injection site, and edema of the hands and feet. He was then given a diagnosis of Kawasaki disease (KD); he became afebrile 22 hours after administration of intravenous gamma globulin (2 g/kg) and aspirin. No coronary artery involvement was detected by echocardiography, either on admission or 4 weeks later...

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