Abstract: Objective To explore the clinical features, diagnosis and treatment of incomplete Kawasaki disease (KD) with parapharyngeal space inflammation as the main manifestation. Methods The clinical data of a KD patient with parapharyngeal space inflammation admitted in December 2019 were retrospectively analyzed, and literature review was conducted. Results A 6 -year-old boy presented with fever for 9 days. He had neck pain with enlarged lymph nodes and a few skin rashes in the trunk. C-reactive protein and erythrocyte sedimentation rate were significantly increased, and antipyretic and antibiotic treatment was not effective. The echocardiography showed a slight dilation of the left coronary artery. Neck MRI showed inflammation of the parapharyngeal space. After the treatment with high-dose gamma globulin and aspirin, the boy's body temperature returned to normal, the swelling and pain of the neck disappeared, and the inflammation index gradually decreased to normal. Reexamination of neck MRI showed that the lesion was smaller than before, and the typical membranous peeling of skin transition occurred in the fingernail bed of the child on the 14th day. Diagnosis of incomplete KD was confirmed. A total of 40 foreign literatures were retrieved and more than 200 cases were reported. One Chinese literature was retrieved and one case was reported. Conclusion? KD with inflammation of the posterior pharyngeal wall or parapharyngeal space as the first manifestation is rare and requires early clinical evaluation and treatment.

Key words: Kawasaki disease;? parapharyngeal space;? inflammation