A Case of Brucellosis Associated with Histiocytic Necrotizing Lymphadenitis: A Diagnostic Pitfall.

Abstract

Human cases of brucellosis are rare in the United States and difficult to diagnose. We report a case of a young female who underwent a diagnostic investigation of fever of unknown origin, which included a lymph node biopsy. The biopsy was consistent with Kikuchi’s Disease, or histiocytic necrotizing lymphadenitis, an entity where the major differential diagnosis is systemic lupus erythematosus. Interestingly, serologic studies supported the diagnosis of brucellosis. Brucellosis has rarely been associated with histiocytic necrotizing lymphadenitis. This association has never been reported in the United States, thus suggesting that brucellosis should be considered in the differential for histiocytic necrotizing lymphadenitis, along with lupus-like autoimmune disease. As the prognosis and treatment of histiocytic necrotizing lymphadenitis, brucellosis, and systemic lupus erythematosus are distinct, it is important to differentiate these entities. [J Interdiscipl Histopathol 2013; 1(5.000): 274-279

An interesting case of pyrexia of unknown origin

“…But in certain cases, steroids can be started when the effects are debilitating. 9 This duo has already been reported in the literature. The incidence of Kikuchi disease itself is rare, and such a co-existent duo will be pretty uncommon.…”