Dermatopathic lymphadenitis imitating a deep neck space infection

Abstract

Introduction: Dermatopathic lymphadenitis (DL) represents a benign form of reactive lymph node hyperplasia. Symptoms attributed to DL alone are expected to be mild. The purpose of this study was to present a rare case of DL in a young girl that manifested as a deep neck space infection. Differential diagnostic process and the difficulties we faced in managing this case will be discussed.

Case presentation: A 10-year-old girl with clinical signs indicative of deep neck space infection was admitted in our department. Her clinical course and imaging findings strongly suggested the presence of a deep cervical abscess, although this was not proven in the operating room, in 2 operating sessions. The complete clinical picture developed during her in-hospital care set the suspicion of Kawasaki disease; however, the results of the histology of the cervical nodes were consistent with dermatopathic lympadenitis, which was the final diagnosis in our patient.

Conclusion: Dermatopathic lymphadenitis is a rare diagnosis in the head and neck area. However, it must be included in the differential diagnostic process because its management differs from that of other head and neck lymphadenopathies, keeping in mind that the spectrum of its clinical symptomatology may vary from a mild lymph node enlargement to acute symptoms and signs of a deep neck infection.