Think beyond TB lymphadenitis - Kikuchi fujimoto lymphadenitis

Abstract

Kikuchi-Fujimoto disease (KFD) is an extremely unusual lymphadenopathy that typically affects females between the ages of 20 and 40, but the aetiology is still unclear. A 28-year-old female presented with right-sided cervical lymph nodes, but there was no history of fever, anorexia, or loss of appetite. Ultrasonography of the patient's neck revealed bilateral cervical lymphadenopathy. Both the acid-fast bacilli smear and GeneXpert tests returned negative results. Histopathology revealed the presence of lymphocytes and histiocytes mixed with karyorrhectic debris. Immunohistochemistry markers support the diagnosis of Kikuchi-Fujimoto lymphadenitis. This case demonstrates that early recognition of KFD reduces unnecessary evaluations and treatments and patient suffering. KFD is a self-limiting disease that requires a systematic approach for a diagnosis; once the diagnosis is made and confirmed by techniques such as immunohistochemistry, symptomatic treatment alone would suffice in the majority of cases. The commonest presentation is an acute or subacute febrile illness associated with cervical lymphadenopathy.