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

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.

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Kikuchi-Fujimoto Disease: A Report of 3 Cases

Ear Nose & Throat Journal ◽

10.1177/014556130708600720 ◽

2007 ◽

Vol 86 (7) ◽

pp. 412-413 ◽

Cited By ~ 4

Author(s):

Eimear Phelan ◽

Emer Lang ◽

Peter Gormley ◽

John Lang

Keyword(s):

Weight Loss ◽

Cervical Lymphadenopathy ◽

Lymph Node Biopsy ◽

Accurate Diagnosis ◽

Histiocytic Necrotizing Lymphadenitis ◽

Kikuchi’S Disease ◽

Node Biopsy ◽

Night Sweats ◽

Necrotizing Lymphadenitis ◽

Kikuchi's Disease

Cervical lymphadenopathy has many underlying etiologies. One of its rare causes is Kikuchi-Fujimoto disease (Kikuchi's disease, histiocytic necrotizing lymphadenitis). We discovered such a cause in a 37-year-old woman who had presented with malaise, night sweats, and weight loss in addition to cervical lymphadenopathy. We based our diagnosis on excisional lymph node biopsy. We also review 2 other cases of Kikuchi's disease that were diagnosed by others at our institution. Clinically and histologically, Kikuchi's disease is very similar to lymphoma, and distinguishing the two is difficult. However, despite the fact that Kikuchi's disease is benign, an accurate diagnosis is important because misdiagnosis might lead to unnecessary surgery and/or chemotherapy.

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Kikuchi necrotizing lymphadenopathy: a tip of the iceberg disease?

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213326 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1602

Author(s):

Sushil Singla ◽

Mohitesh Kumar ◽

Vinod Kumar Jat ◽

Deepika Parwan

Keyword(s):

Lymph Node ◽

Laboratory Test ◽

Young Patient ◽

Healthy Individual ◽

Cervical Lymphadenopathy ◽

Lymph Node Biopsy ◽

Histiocytic Necrotizing Lymphadenitis ◽

Benign Condition ◽

Node Biopsy ◽

Necrotizing Lymphadenitis

Kikuchi-Fujimoto disease (KFD) is a rare benign condition also called histiocytic necrotizing lymphadenitis, which typically presented as fever with cervical lymphadenopathy in previously healthy individual. We presented a case of 11 year old boy with fever and cervical lymphadenopathy since 2 months. Lymph node biopsy was performed which suggested of KFD and was treated symptomatically. KFD incidence is rare but clinicians should be alert if young patient comes with fever and cervical lymphadenopathy to lower the chance of unwanted laboratory test and harmful treatment.

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Take a second look: it's Kikuchi’s disease! A case report and review of literature

Clinics and Practice ◽

10.4081/cp.2018.1095 ◽

2018 ◽

Vol 8 (4) ◽

Cited By ~ 3

Author(s):

Oana Joean ◽

Thea Thiele ◽

Mieke Raap ◽

Reinhold E. Schmidt ◽

Matthias Stoll

Keyword(s):

Differential Diagnosis ◽

Lymph Node Biopsy ◽

Review Of Literature ◽

Common Cause ◽

Systemic Involvement ◽

Kikuchi’S Disease ◽

Node Biopsy ◽

Necrotizing Lymphadenitis ◽

Generalized Lymphadenopathy ◽

Kikuchi's Disease

Generalized lymphadenopathy is a common cause of concern for both patients and clinicians. Possible etiologies include infections, malignancies and autoimmune diseases. Kikuchi Fujimoto disease (KFD) is a hyperergic condition that presents with fever, lymphadenopathy and can include systemic involvement, thus being easily mistaken for the above-mentioned entities. We report the case of a previously healthy 18-year-old male who presented with a selflimiting generalized lymphadenopathy, high fevers, skin vasculitis and polyserositis. The lymph-node biopsy revealed a histiocytotic necrotizing lymphadenitis, suggestive of Kikuchi’s disease. This case emphasizes the importance of KFD in the differential diagnosis of lymphadenopathy, especially in young adults.

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Kikuchi's Disease: A Case Report

Faridpur Medical College Journal ◽

10.3329/fmcj.v8i2.20395 ◽

2014 ◽

Vol 8 (2) ◽

pp. 96-98

Author(s):

Md Shafiq-Ur Rahman ◽

Golam Muktadir ◽

SK Abdul Momen Ahmed

Keyword(s):

Early Recognition ◽

Cervical Lymphadenopathy ◽

Needle Aspiration ◽

Lymph Node Biopsy ◽

Unknown Etiology ◽

Histiocytic Necrotizing Lymphadenitis ◽

Cervical Lymphadenitis ◽

Kikuchi’S Disease ◽

Necrotizing Lymphadenitis ◽

Kikuchi's Disease

Kikuchi's disease is also known as histiocytic necrotizing lymphadenitis. Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis, is a rare benign, self-limiting cervical lymphadenitis of unknown etiology. It predominantly affects young women and can closely mimic infective and immunological disorders. Recognition of this condition is crucial, specially because it can easily be mistaken for tuberculosis, lymphoma, or even adenocarcinoma. We report an 18 years old girl who presented with fever and cervical lymphadenopathy. She had multiple enlarged cervical lymphadenopathy. Examination of other systems was normal. Laboratory investigations were also normal. Fine needle aspiration cytology of the cervical node was not done. The patient took a course of oral antibiotics. Since the patient did not respond, lymph node biopsy was done and the histological features suggested the diagnosis of Kikuchi's disease. The Patient was treated symptomatically and complete remission occurred in few weeks. Although the incidence of Kikuchi-Fujimoto disease is rare, clinicians should be aware of this condition as early recognition of the disease will minimize potentially harmful and unnecessary evaluations and treatments. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20395 Faridpur Med. Coll. J. 2013;8(2): 96-98

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Baffled with fever and lymphadenopathy: neither infection nor malignancy, think Kikuchi disease

BMJ Case Reports ◽

10.1136/bcr-2020-238914 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238914

Author(s):

Ali Hussain ◽

Mohsin Gondal ◽

Hira Yousuf ◽

Mubashar Iqbal

Keyword(s):

Young Women ◽

Cervical Lymphadenopathy ◽

Complete Recovery ◽

Symptomatic Treatment ◽

Lymph Node Biopsy ◽

Asian Woman ◽

Unknown Aetiology ◽

Benign Condition ◽

Node Biopsy ◽

Clinical Investigations

Kikuchi disease is a rare, benign condition of unknown aetiology, which usually involves young women and is characterised by cervical lymphadenopathy and fever. Herein, we are reporting a case of a young Asian woman, who presented with fever and lymphadenopathy raising possibility of either infection or malignancy but after appropriate clinical investigations including lymph node biopsy, it turned out to be Kikuchi disease. She made an uneventful complete recovery with only symptomatic treatment.

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Kikuchi-Fujimoto disease with multiple extra-nodal features - A clinical mimic

Reumatismo ◽

10.4081/reumatismo.2019.1130 ◽

2019 ◽

Vol 71 (2) ◽

pp. 105-107

Author(s):

C.A. Mansoor ◽

Z. Shemin

Keyword(s):

Lymph Node ◽

Lupus Erythematosus ◽

Maculopapular Rash ◽

Lymph Node Biopsy ◽

High Grade Fever ◽

Extranodal Involvement ◽

Kikuchi’S Disease ◽

Node Biopsy ◽

Extranodal Manifestations ◽

Kikuchi's Disease

Extranodal involvement in Kikuchi’s disease is uncommon. A 31-year-old previously healthy Indian woman was admitted with high grade fever, multiple joint pain and skin rash for 3 weeks. She had negative anti-nuclear antibodies and had features of Kikuchi’s disease on lymph node biopsy. She also had multiple extranodal manifestations including erythematous maculopapular rash, symmetric polyarthritis and hepatosplenomegaly. Kikuchi’s disease with extranodal involvement can clinically mimic diseases like hematological malignancies, connective tissue disorders and certain infections. A lymph node biopsy plays a crucial role in making an accurate diagnosis by excluding other diseases. A discussion on the importance of differentiating Kikuchi’s disease from systemic lupus erythematosus is included.

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Kikuchi-Fujimoto Disease Associated with Symptomatic CD4 Lymphocytopenia

Case Reports in Rheumatology ◽

10.1155/2014/768321 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Meera Yogarajah ◽

Bhradeev Sivasambu

Keyword(s):

Oral Candidiasis ◽

Cervical Lymphadenopathy ◽

Lymph Node Biopsy ◽

Cd4 Count ◽

African American Female ◽

Retroviral Infection ◽

Benign Condition ◽

Hiv Rna ◽

Node Biopsy ◽

First Case

Kikuchi-Fujimoto disease is a rare benign condition of necrotising histiocytic lymphadenitis with unknown aetiology. We describe here a 30-year-old African American female who presented with fever, generalized rash, cervical lymphadenopathy, and oral candidiasis and was found to have Kikuchi-Fujimoto disease on lymph node biopsy with low CD4 count. The initial presentation was concerning for acute retroviral infection. Her HIV serology and HIV RNA PCR were negative however she had low CD4 count with reversal of CD4/CD8 ratio. Although low CD4 count has been associated with autoimmune disease, it has not been described with Kikuchi-Fujimoto disease. We report the first case of Kikuchi-Fujimoto disease associated with symptomatic CD4 lymphocytopenia.

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Case Report: Kikuchi: The great mimicker

F1000Research ◽

10.12688/f1000research.14758.1 ◽

2018 ◽

Vol 7 ◽

pp. 520

Author(s):

Kevin Bryan Lo ◽

Anna Papazoglou ◽

Lorayne Chua ◽

Nellowe Candelario

Keyword(s):

Case Report ◽

Lymph Node ◽

Disease Patient ◽

Cervical Lymphadenopathy ◽

Hematologic Malignancies ◽

Lymph Node Biopsy ◽

Benign Disease ◽

Node Biopsy ◽

Necrotizing Lymphadenitis ◽

Serious Disease

Kikuchi-Fujimoto disease is a form of a benign necrotizing lymphadenitis which is most commonly misdiagnosed as tuberculosis and or lymphoma, usually more common among young adults in Asia. It is a benign disease but can mimic a lot of other disease processes spanning infectious, rheumatologic and even hematologic malignancies. Our patient presented with prolonged fever and lymphadenopathy. Initial considerations were lymphoma and a nonspecific viral infection. A CT scan showed diffuse cervical lymphadenopathy with lacrimal gland involvement. An excisional lymph node biopsy was done which revealed Kikuchi disease. Patient was given steroids with immediate response with defervescence. Kikuchi is a disease with many mimics and a complete workup is needed to exclude serious disease like malignancy.

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Cervical lymphadenopathies: a diagnostic crisis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20174310 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1490

Author(s):

Priya Joy ◽

G. Gayathri ◽

V. Gangadharan

Keyword(s):

Lymph Nodes ◽

Elevated Serum ◽

Cervical Lymphadenopathy ◽

Kimura’S Disease ◽

Cervical Lymph Nodes ◽

Benign Condition ◽

Serum Ige ◽

Kikuchi’S Disease ◽

First Case ◽

Kikuchi's Disease

Cervical lymphadenopathy refers to lymphadenopathy of the cervical lymph nodes. The causes are varied, and may be inflammatory, degenerative, infective or neoplastic. The first case presented here is of a 29-year old male presented with h/o recurrent progressive right sided painless swelling in the infraparotid region with cervical lymphadenopathy for past one year. Swelling was 6×6cm, nontender, firm mass. Cervical lymph nodes were palpable. He had raised eosinophil counts and elevated serum IgE levels. Biopsy showed abundant eosinophilic infiltration with microabscess suggestive of Kimura’s disease. Second case reported here is of a 17-year old female patient presented with fever for 3 weeks with cervical lymphadenopathy. The lymph node was 3×2cm, tender and firm. Routine blood investigations showed anemia. Biopsy showed lymph nodes composed of sheets of macrophages with crescent shaped nuclei with areas of necrosis and karyhorrhexis suggestive of Kikuchi’s disease. Kimura’s disease is a relatively uncommon chronic inflammatory benign condition mostly affecting the lymph nodes, subcutaneous tissue and salivary glands of head and neck region. It is seen in males in their second decade of lives. Peripheral eosinophilia, regional lymphadenopathy and elevated serum IgE levels are characteristics of Kimura’s disease. Kikuchi-Fujimoto disease is a benign, idiopathic and self-limited disease. Affects young females between 20-35 years of age. Usually there will be localized painful lymphadenopathy, fever and leukopenia. Kikuchi disease runs a benign course and resolves in several weeks to months. The two cases are presented to make clinicians aware of Kimura’s disease and Kikuchi’s disease as a differential diagnosis of cervical lymphadenopathy and to avoid the diagnostic dilemma both clinically and histopathologically.

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