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Case Reports
. 2021 Aug 3;21(1):740.
doi: 10.1186/s12879-021-06048-0.

Kikuchi-Fujimoto disease presenting in a patient with SARS-CoV-2: a case report

Samuel D Racette  1 , Borislav A Alexiev  2 , Michael P Angarone  3 , Ajay Bhasin  4   5 , Kaitlin Lima  6 , Lawrence J Jennings  2 , Senthil Balasubramanian  7 , Akihiro J Matsuoka  8   9   10
Affiliations
Case Reports

Kikuchi-Fujimoto disease presenting in a patient with SARS-CoV-2: a case report

Samuel D Racette et al. BMC Infect Dis. .

Abstract

Background: We present a yet to be described association of SARS-CoV-2 infection with Kikuchi-Fujimoto disease.

Case presentation: A 32-year-old physician with history of SARS-CoV-2 infection presented to the emergency department with 2 weeks of fever, chills, and right sided cervical lymphadenopathy. He was treated empirically for presumed folliculitis with worsening of symptoms leading to repeat presentation to the emergency department. Extensive workup was unrevealing of an infectious cause and needle biopsy of the lesion was unrevealing. An excisional lymph node biopsy revealed follicular hyperplasia with necrotic foci showing abundance of histiocytes at the edge of necrosis with CD8 predominance of T-cells. Final diagnosis was deemed to be Kikuchi-Fujimoto disease. Antibiotic therapy was discontinued, and the patient's symptoms resolved with steroid therapy and expectant management.

Conclusions: This is the first report of a patient developing Kikuchi-Fujimoto disease following SARS-CoV-2 infection. Clinicians should be aware of Kikuchi-Fujimoto disease as a possibility when approaching patients with hyper-inflammatory states who present with cervical lymphadenopathy.

Keywords: COVID-19; Cervical lymphadenopathy; Kikuchi-Fujimoto Syndrome; SARS-CoV-2.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Representative coronal (a) and axial (b) cuts of a CT neck with contrast displaying right sided cervical lymphadenopathy throughout levels 2-4 along the jugular chain of lymph nodes
Fig. 2
Fig. 2
1A. Necrotizing lymphadenitis with KFD-like features. Note expanded paracortex and wellcircumscribed area of necrosis. Hematoxylin-eosin stain, x40. 1B. Necrotizing lymphadenitis with KFD-like features. Note abundant karyorrhectic nuclear debris and a large accumulation of histiocytes. Neutrophils are absent. Hematoxylin-eosin stain, x200. 1C. Necrotizing lymphadenitis with KFD-like features. Histiocytes are positive CD68. CD68 stain, x100. 1D. Necrotizing lymphadenitis with KFD-like features. Clusters of plasmacytoid dendritic cells are highlighted by CD123 stain. CD123 stain, x100
See this image and copyright information in PMC

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