Kikuchi's Disease: A Rare Cause of Fever and Lymphadenopathy

Abstract

Kikuchi’s disease is a benign condition that occurs in women. A young woman presented to the hospital with fevers and cervical lymphadenopathy. Infectious work-up was negative except for streptococcus pharyngitis. Imaging studies revealed the presence of diffuse cervical and axillary lymphadenopathy. The fevers persisted and she underwent excisional cervical lymph node biopsy that revealed histiocytic necrotizing lymphadenitis corresponding to a benign diagnosis of Kikuchi’s disease. Three months later, the patient was afebrile and there was complete resolution of the cervical lymphadenopathy.

Association between Kikuchi-Fujimoto disease and Streptococcus pneumoniae infection

“…KFD has also been reported in patients with AIDS [7]. Other infectious agents related have been Toxoplasma gondii, Yersinia enterocolitica and Pasteurella multocida [8,9].…”

Kikuchi Fujimoto Disease: The First Reported Case in Mongolia

“…The diagnosis of KFD is confirmed by immunohistochemical staining of CD68 positive plasmacytoid monocytes and histiocytes [17,18]. Differential diagnosis for KFD include lymphoma, tuberculous adenitis and SLE [4].…”

Kikuchi-Fujimoto disease: a rare but important differential diagnosis for lymphadenopathy

“…Microscopic features including proliferation of large atypical immunoblasts and plasmacytoid dendritic cells with a high-proliferative index and necrosis may be misdiagnosed as non-Hodgkin or Hodgkin lymphoma. However, KFD does have certain characteristic findings that can be used to differentiate it from other aetiologies of lymphadenopathy 5. For example, distortion rather than complete effacement of architecture, patent sinuses, the presence of histiocytes and karyorrhexis, absence of neutrophils and eosinophils and inconspicuous mitoses can help differentiate KFD from lymphoma 2.…”

“…There have been reports where patients have been treated with chemotherapy as a result of a misdiagnosis 1 5. This reflects the subtle differences in the clinical presentation and histology of these differential diagnoses but also a lack of awareness of this disease among clinicians.…”