Kikuchi-Fujimoto Disease: A Rare Case Report.pdf

Kikuchi-Fujimoto Disease - A Case Report

Background: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, sporadic condition characterized by high fever, swollen lymph nodes, skin rashes, and headaches. It occurs predominantly in Japan, affecting young adults (20-30 years old) with slightly more females affected. The exact cause remains unknown, though bacterial/viral agents or autoimmune conditions are suspected.

Case Presentation: A 57-year-old man presented with a neck tumor, redness, and severe pain lasting for four months. He had a history of persistent coughing, sputum production, fatigue, weight loss, night sweats, but no high fever. Blood tests revealed elevated CRP (42.4) and liver enzymes (ASAT 14.0, ALAT 16.0, GGT 48.0). A biopsy of the enlarged lymph node showed central necrosis with neutrophils surrounded by histiocytes, foam cells, giant multi-core "foreign body" cells, and keratin materials.

Diagnosis: The histopathological findings confirmed KFD. Immunohistochemistry revealed a predominant population of CD68+ cells and moderate expression of CD3+. Microbiological testing identified Enterococcus faecalis in the lymph node sample.

Treatment & Outcome: Radical surgical removal of the lymph node tumor was performed with complete recovery post-surgery. The patient was treated conservatively with antibiotics (Ciprofloxacin, Moxifloxacin) for six weeks, leading to full recovery and normalization of lymph node size within that period. Relapse is rare (3%) and mortality even rarer in this benign, self-limiting disease.