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Retropharyngeal cellulitis: a manifestation of Kawasaki disease in children.

Kawasaki disease (KD) or mucocutaneous lymph node syndrome is an acute febrile illness with prominent vasculitic features. The cause is unknown and the disease is seen most commonly in young children. After its initial description in Japan, the disease was thought to be rare in the United States, but recognition has dramatically increased over the past decade. Common symptoms of the disease for which the otolaryngologist may be initially consulted include inflammation of the lips and oral cavity and acute cervical lymphadenopathy. We present a case of Kawasaki disease initially complicated by retropharyngeal soft tissue swelling. Similar reports are rare in the pediatric literature; however, no such reports appear in the otolaryngology literature.

Cellulitis↗

Mucocutaneous leishmaniasis presenting as facial cellulitis.

We report a case of mucocutaneous leishmaniasis caused by Leishmania viannia braziliensis. Despite several courses of both oral and intravenous antibiotics no improvement was seen. This case highlights the importance of taking a thorough history, including details of recent travel, and considering rarer causes when no improvement with antibiotics is seen. Our patient was infected with a particularly virulent strain and destruction of the mucous membranes is not uncommon. Rapid diagnosis and treatment are therefore crucial.

Adolescent↗

Leak of the bypassed stomach after laparoscopic gastric bypass, presenting as abdominal wall cellulitis.

The development of surgical staplers devised for laparoscopy has enabled advancements in complex laparoscopic procedures, such as gastric bypass. This procedure, considered by many as the gold standard for bariatric surgery, is now frequently performed laparoscopically, with the advantages inherent in the minimally invasive approach. Technical failure of surgical staplers is, however, a well known complication of these devices in digestive surgery. We report the case of a leak of the bypassed stomach into the abdominal wall through a trocar site following laparoscopic gastric bypass. The mechanisms responsible for this life-threatening complication and the options to avoid it are discussed.

Abdominal Wall↗