Abstract
Kikuchi-FujimotoDisease (KFD), also known ashistiocyticnecrotizinglymphadenitis, is a rare cause of cervical lymphadenopathy. Patients usually present with localized lymphadenopathy, fever and fatigue. Because of the poorly understood etiology, it can be mistaken for an infectious disease or even malignance. Here we discuss a case of KFD that initially presented with left sided cervical lymphadenopathy that later progressed to left supraclavicular lymph nodes. Due to its characteristic overlap with other disorders like tuberculous lymphadenitis and lymphoma, KFD remains an arduous diagnosis for physicians. Therefore, one should be made aware of symptoms that can lead to misdiagnosis in patients.
Highlights
Kikuchi-Fujimoto Disease (KFD), known as histiocytic necrotizing lymphadenitis, is a rare cause of cervical lymphadenopathy
- We have added the clarification for interferon-gamma release assay (IGRA) being inconclusive. - We have added details regarding no growth on the culture - We have added why PPD was not performed as IGRA was done instead of it. - We have not changed the term “increase in lymphocytes” as the total percentage was increased as mentioned per table. - We have added as to why anti tuberculosis therapy was delayed. - We have corrected a EBV typo. - We have changed the area to south Asia throughout
Any further responses from the reviewers can be found at the end of the article Introduction Kikuchi-Fujimoto Disease (KFD) is known to occur both in the juvenile and adult population
Summary
Initial lab investigations included complete blood count with total and differential leukocyte count, metabolic profile, erythrocyte sedimentation rate (ESR) and lactate dehydrogenase (LDH). This was to rule out any possibility of lymphadenitis, or neoplastic disorder. Further investigations were ordered to determine the size and extent of the lymphadenopathy These included ultrasonography of the neck and abdomen, to visualize any hidden lymphadenopathy that might have been missed during the initial physical examination; chest x-ray, to rule out any active tuberculosis; and interferon-gamma release assay. An excisional lymph node biopsy from the anterior cervical chain was performed and on histopathological analysis it showed necrotizing lymphadenitis with partial alteration of structure by clusters of histiocytic and interspersed nuclear debris.
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