We present two case reports of older children who initially presented
with cervical lymphadenitis and who were eventually diagnosed and trea
ted for Kawasaki syndrome (KS). Both children presented with unilatera
l cervical lymphadenopathy and fever and later developed additional cl
inical features of KS, including cardiac aneurysms in one of the patie
nts. Of the five KS clinical criteria which accompany fever for 5 days
, cervical lymphadenopathy of greater than or equal to 1.5 cm is the l
east commonly found. Both patients were treated as having bacterial ad
enitis prior to the diagnosis of KS. We hope to illustrate that in the
case of atypical cervical lymphadenitis, KS should be carefully consi
dered in the differential diagnosis.