Diagnostic challenges and management of kikuchi-fujimoto disease: a rare case report.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI:10.1097/MS9.0000000000002861
Jatin Motwani, Ameet Kumar, Laiba Azhar, Ayaan Ahmed Qureshi, Zukhruf Fatima, Saif Khalid, Verkha Kumari, Syeed Mahmud Nishat
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Abstract

Introduction: Kikuchi-Fujimoto disease, otherwise referred to as histiocytic necrotizing lymphadenitis, is a rare and self-limiting disorder characterized by fever, lymphadenopathy, and upper respiratory symptoms. The main target of the illness is young Asian adults and is more prevalent in females. This disease probably has viral triggering or autoimmune responses, and diagnosis depends on histopathological examination.

Case presentation: We present a case of an 18-month history of recurrent high-grade fever with marked weight loss and an enlarged occipital lymph node in a 42-year-old diabetic male from Karachi, Pakistan. The patient's symptoms did not subside despite being hospitalized several times and receiving multiple courses of antibiotics. Physical examination revealed a firm, non-tender occipital lymph node. Laboratory studies showed mild anemia and leukopenia, raised inflammatory markers, but unremarkable imaging studies and autoimmune tests. An excisional biopsy of the lymph node confirmed KFD with necrotizing lymphadenitis showing characteristic karyorrhectic debris.

Discussion: This case epitomizes the diagnostic challenges of KFD, which can mimic a host of conditions like tuberculosis and lymphoma. The recurrent fevers in the presence of significant weight loss and failure to respond to the usual treatments raised suspicion for further detailed investigation. Excisional biopsy established the diagnosis and differentiated it from other conditions. The patient's rapid improvement with corticosteroid therapy aligns with established treatment protocols for KFD, thus proving its efficacy.

Conclusion: KFD should be included in the differential diagnosis of fever of unknown origin. Diagnosis and management of KFD can avoid misdiagnosis and hence improve patient outcomes.

菊chi-fujimoto病的诊断挑战和治疗:罕见病例报告。
简介:Kikuchi-Fujimoto病,也被称为组织细胞坏死性淋巴结炎,是一种罕见的自限性疾病,以发热、淋巴结病变和上呼吸道症状为特征。这种疾病的主要目标是年轻的亚洲成年人,在女性中更为普遍。这种疾病可能有病毒触发或自身免疫反应,诊断依赖于组织病理学检查。病例介绍:我们报告一例来自巴基斯坦卡拉奇的42岁男性糖尿病患者,有18个月的复发性高热病史,伴有明显的体重减轻和枕部淋巴结肿大。尽管患者多次住院并接受了多个疗程的抗生素治疗,但症状并未消退。体格检查显示枕骨淋巴结坚硬,无压痛。实验室研究显示轻度贫血和白细胞减少,炎症标志物升高,但影像学检查和自身免疫检查不显著。淋巴结的切除活检证实KFD伴坏死性淋巴结炎,表现为特征性的核团性碎片。讨论:这个病例集中体现了KFD的诊断挑战,它可以模仿许多疾病,如结核病和淋巴瘤。在体重明显减轻和常规治疗无效的情况下反复发烧,引起了进一步详细调查的怀疑。切除活检确定了诊断并将其与其他疾病区分开来。患者通过皮质类固醇治疗的快速改善符合既定的KFD治疗方案,从而证明了其疗效。结论:不明原因发热应纳入KFD鉴别诊断。KFD的诊断和管理可以避免误诊,从而改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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