Kikuchi-Fujimoto Disease: A Case Report of Prolonged Fever and Lymphadenopathy in a Young Girl

Abstract

Kikuchi-Fujimoto disease (KFD) is a benign and self-limited disorder that usually presents with regional cervical lymphadenopathy and fever. We report a case of a 12-year-old female who complained of fever, night sweating, significant weight loss, and tender right cervical lymph node enlargement for 2 months. A full workup including laboratory tests and imaging studies, an excisional biopsy, and histopathological analysis were done, and the diagnosis of KFD was confirmed. The patient was treated with analgesia and oral prednisolone, resulting in good improvement. A high degree of clinical suspicion is imperative for physicians, given the rarity of the disease and the associated diagnostic challenges.

Keywords: Kikuchi-Fujimoto disease; fever; histiocytic necrotizing lymphadenitis; lymphadenopathy; systemic lupus erythematosus.

Figure 1.

Excisional biopsy of the right cervical lymph node (Kikuchi lymphadenitis). (A) Section revealed lymph node with distorted architecture by irregular areas of paracortical necrosis (arrow) (H&E, 4×). (B) These areas show a zone of central necrosis surrounded by pale zone of mononuclear cells (H&E, 10×). (C) The mononuclear cells are composed of lymphocytes, histiocytes, and plasmacytoid cells with no neutrophils. Frequent apoptosis and abundant karyorrhectic debris are noted (arrow) (H&E, 40×). (D) CD3 immunostaining revealed predominant reactive T lymphocytes. (E) CD68 immunostaining revealed increased histiocytes with many crescentic forms. (F) CD20 highlights scattered reactive B lymphocytes.