Temporal Abscess Complicating Otomastoiditis: Another Presentation Of Kawasaki Disease

Incomplete and atypical forms of Kawasaki disease increasingly pose a diagnostic challenge. We report a case of atypical presentation of Kawasaki disease with otomastoiditis complicated by temporal abscess and review the literature of this topic. A 4-year-old boy, presenting with Kawasaki disease, was treated with intravenous immunoglobulin and discharged after a week-long hospitalization. He presented with recurrence of fever and an acute evolving left temporal swelling. Computed Tomography scan showed left otomastoiditis with collection and infiltration of the temporal area. The oto-rhino-laryngological manifestations of Kawasaki disease are an integral component of the diagnosis. We found, in addition, a temporal abscess complicating otomastoiditis. All children with Kawasaki disease should have an oto-rhino-laryngological examination, especially if fever persists or recurs after treatment with immunoglobulin.