咽後膿瘍を疑わせ気道閉塞をきたした不全型川崎病の1例

A case of Kawasaki disease,an example of a closed respiratory failure type suspected as retropharyngeal abscess

Ⅰ　はじめに

　咽後膿瘍は病状の進行に伴いしばしば気道閉塞をきたすことがあり，緊急手術を必要とする耳鼻咽喉科救急疾患の一つである。その原因の主たるものは咽頭の細菌感染の波及が挙げられるが，一方で抗菌薬に対する反応性が乏しく，一般の細菌感染による病態と異なり診断に苦慮する咽後膿瘍も稀に経験する。

　今回われわれは発熱，咽頭痛で発症し，咽後膿瘍が疑われ，初診後24時間以内に気道閉塞をきたした年長児の不全型川崎病の1例を経験したので報告する。

　A 11-year-old female patient presented with high fever and sore throat,and diagnosed as atypical Kawasaki disease.

　On admission, she suffered from respiratory distress caused by laryngeal-edema and retropharyngeal abscess which grew rapidly. Endotracheal intubation was undertaken one day after admission.

　After 8 days of admission, CT scan showed deterioration of laryngeal-edema and retropharyngeal findings, and tracheostomy was done.

　Kawasaki disease was finally suspected, and she was treated with high dose of γ-globlin（1 g/kg/day）after consulting with pediatrician.

　After the treatment,the body temperature decreased and neck findings were improved.