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Case Reports
. 2020 Nov 5:8:2050313X20962640.
doi: 10.1177/2050313X20962640. eCollection 2020.

Evaluation of a unilateral neck mass in a 16-year-old female: Kikuchi-Fujimoto disease with superimposed bacterial lymphadenitis

Joseph Burns  1 , Shivany Pathania  1 , Rebecca Griesser  1 , Jolanta Norelli  1   2 , Kelly Gilgeours  3 , Jessica Tugetman  1 , Nancy Palumbo  1
Affiliations
Case Reports

Evaluation of a unilateral neck mass in a 16-year-old female: Kikuchi-Fujimoto disease with superimposed bacterial lymphadenitis

Joseph Burns et al. SAGE Open Med Case Rep. .

Abstract

The evaluation of pediatric neck masses offers the opportunity for consideration of a diverse range of pathologies, from infectious to neoplastic. A 16-year-old female presented with 2 weeks of worsening swelling and pain of a left-sided neck mass. Findings were consistent with Epstein-Barr virus and cytomegalovirus coinfection, but considering profound lymphadenopathy of the supraclavicular, mammillary, and axillary chains, further investigations were undertaken. Hematopathologic examination demonstrated necrotizing lymphadenitis, consistent with Kikuchi-Fujimoto disease. A diagnosis of Kikuchi-Fujimoto disease alongside chronic bacterial lymphadenitis was made on the basis of her response to clindamycin, and the chronic course of her illness and subsequent persistence of the swelling managed on an outpatient basis. The case study describes the initial diagnostic considerations and management as well as a review of the disease pathology.

Keywords: Hospital medicine; Kikuchi-Fujimoto disease; Pediatric neck mass.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Axial CT with contrast. (a) Left-sided neck mass. (b) 1.8-cm-long axis lymph node anterior to the right psoas muscle. (c) 1.9-cm-long axis lymph node in the anterior aspect of the superior mesenteric vessels.
See this image and copyright information in PMC

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