Kikuchi-Fujimoto Disease: A Rare Condition Mimicking Sepsis.

Abstract

Introduction: Kikuchi-Fujimoto disease is a self-limited disease which is also known as histiocytic necrotizing lymphadenitis. The Kikuchi-Fujimoto disease is a rare cause of cervical lymphadenopathy, with or without systemic signs, such as fever, leukopenia, and skin rashes.

Case report: We presented a case of Kikuchi-Fujimoto disease in a 29-year-old female mimicking sepsis after a COVID-19 infection. Clinical examination revealed stable vitals and multiple diffuse non-tender bilateral cervical and axillary lymph adenopathy with hepatosplenomegaly. The patient's blood parameters showed leukopenia, raised erythrocyte sedimentation rate, lactate dehydrogenase, microcytic hypochromic anemia with normal renal and liver function tests. The patient was treated with broad spectrum intravenous antibiotics and subcutaneous neupogen with a clinical suspicion of sepsis. The patient then underwent a CT scan which validated the clinical findings. Although the fever subsided, a persistent cervical lymphadenopathy was observed and the biopsy confirmed it to be necrotising lymph adenitis secondary to Kikuchi-Fujimoto disease. This patient has been regularly monitored and has shown resolution of cervical lymphadenopathy.

Conclusion: Clinicians should suspect Kikuchi-Fujimoto disease when patients present with persistent cervical lymphadenopathy unresponsive to initial medical treatment. Lymph node biopsy should be undertaken to rule out Kikuchi-Fujimoto disease and prevent these patients from extensive diagnostic procedures and inappropriate treatment modalities.