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Case Reports
. 2017 Dec 16;11(1):349.
doi: 10.1186/s13256-017-1521-y.

Fever with lymphadenopathy - Kikuchi Fujimoto disease, a great masquerader: a case report

Chamara Dalugama  1 , Indika Bandara Gawarammana  2
Affiliations
Case Reports

Fever with lymphadenopathy - Kikuchi Fujimoto disease, a great masquerader: a case report

Chamara Dalugama et al. J Med Case Rep. .

Abstract

Background: Kikuchi Fujimoto disease is an uncommon benign condition of necrotizing histiocytic lymphadenitis commonly seen in East Asian and Japanese populations. It commonly presents with fever, cervical lymphadenopathy, and elevated inflammatory markers. Diagnosis of Kikuchi Fujimoto disease is based on histopathological studies of the involved lymph nodes. The presentation of Kikuchi Fujimoto disease can mimic many sinister conditions including lymphoma. Treatment is mainly supportive provided that accurate diagnosis is made and sinister conditions like lymphoma ruled out.

Case presentation: We report the case of an 18-year-old Sri Lankan Moor woman who presented with fever and cervical lymphadenopathy for 1 month. She had elevated inflammatory markers with high lactate dehydrogenase and ferritin levels. She had an extensive work-up including an excision biopsy of an involved lymph node and bone marrow biopsy. Finally, a diagnosis of Kikuchi Fujimoto disease was based on histopathology of the lymph node and negative bone marrow biopsy.

Conclusions: Although Kikuchi Fujimoto disease is a self-limiting condition, it is a great masquerader which mimics the clinical features of many sinister conditions including tuberculosis, lymphoma, and adult-onset Still's disease. Early recognition of the disease is of crucial importance in minimizing potentially harmful and unnecessary evaluations and treatments.

Keywords: Fever; Histiocytic necrotizing lymphadenitis; Kikuchi Fujimoto disease.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was not obtained for the publication of this case report as this does not involve sharing of the personal details and photographs of the patient.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Medium-power view of paracortex showing partially effaced architecture and areas of necrosis, infiltrated with nuclear dust; surrounding tissue shows mononuclear cells with ingested nuclear debris
See this image and copyright information in PMC

References

    1. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis. Nippon Ketsueki Gakkai Zasshi. 1972;35:379–80.
    1. Fujimoto Y, Kojima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. New Clinicopathologic Entity. 1972;20:920–7.
    1. Kaur S, Mahajan R, Jain NP, Sood N, Chhabra S. Kikuchi’s Disease – A Rare Cause of Lymphadenopathy and Fever. J Assoc Physicians India. 2014;62(1):54–7. - PubMed
    1. Lin HC, Su CY, Huang CC, Hwang CF, Chien CY. Kikuchi’s disease: a review and analysis of 61 cases. Otolaryngology. 2003;128(5):650–3. - PubMed
    1. Abeysekara RA, Kularatne SA, Waduge R, Sandeepana AG, Bandara JM, Imbulpitiya IV. Kikuchi-Fujimoto’s disease: a case series from Sri Lanka. Ceylon Med J. 2013;58(1):31–3. doi: 10.4038/cmj.v58i1.5362. - DOI - PubMed

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