Recurrent aseptic meningitis in association with Kikuchi-Fujimoto disease: case report and literature review

Abstract

BackgroundKikuchi Fujimoto disease (KFD), or histiocytic necrotising lymphadenitis, is a benign and self-limiting condition characterised by primarily affecting the cervical lymph nodes. Recurrent aseptic meningitis in association with KFD is extremely rare and remains a diagnostic challenge.Case presentationWe report a 28-year-old man who presented 7 episodes of aseptic meningitis associated with KFD over the course of 7 years. Histopathological findings of enlarged lymph nodes led to the diagnosis of KFD. The patient’s headache and lymphadenopathy spontaneously resolved without any sequelae.ConclusionsA diagnosis of KFD should be considered when enlarged cervical lymph nodes are observed in patients with recurrent aseptic meningitis. A long-term prognosis remains uncertain, and careful follow-up is preferred.

Kikuchi-Fujimoto Disease: A Study Of 67 Cases From Coastal South India 

“…A significant majority of our patients recovered after symptomatic management (62.7% of the cases), which was the choice of initial treatment in previous studies as well 1,11,15 . One fourth of the patients in this study were treated successfully with steroids (25.4%).…”

Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

“…Aseptic meningitis is the commonest neurological presentation of Kikuchi's disease [22]. e CSF white cell count may range from 60 to 170 mm 3 and may present as recurrent meningitis within intervals of 1 month-11 years [23]. e diagnosis of KFD as a cause of the aseptic meningitis is made following exclusion of other potential reversible causes.…”

Kikuchi-Fujimoto's disease presenting as acute cerebellar ataxia

“…The most common neurological complication is aseptic meningitis, which is observed in 2.8-9.8% of KFD cases [3]. The disease usually resolves spontaneously within a few months, and the recurrence rate is 3-4% [3]. We report a case with acute cerebellar symptoms following typical cervical lymphadenopathy of KFD.…”

“…KFD is a benign, generally self-limiting condition, which usually affects females under the age of 30 yr. It is primarily localized within the cervical lymph nodes and has various extranodal manifestations, including skin lesions, arthritis, gastrointestinal symptoms and hepatosplenomegaly [2][3][4][5]. Neuro-___________________________________________ *Correspondence: Dr. Praveen-kumar Srikanteswara, Associate Professor of Neurology, Bowring and Lady Curzon Hospitals, Bangalore Medical College and Research Institute, Bangalore 560001, Karnataka, India.…”

“…logical complications are uncommon, and a metaanalysis of 244 KFD cases in 181 published case reports demonstrated 11 (5%) cases with neurological involvement [2]. The most common neurological complication is aseptic meningitis, which is observed in 2.8-9.8% of KFD cases [3]. The disease usually resolves spontaneously within a few months, and the recurrence rate is 3-4% [3].…”