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Case Studies | Medical Science | India | Volume 12 Issue 5, May 2023 | Popularity: 4.4 / 10

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Kikuchi Fujimoto Disease - A Rare Case

Dr. Tuhin Shrivastava, Dr. Urvee Swaika, Dr. Rupali Jain, Dr. Urshlla Kaul, Dr. Vijay Vishwanathan, Dr. Vijay Kamale

Abstract: Patient was a 14 year old male came with complaints of high grade fever and chills since 2 weeks, along with swelling in the left axillary area with tenderness. There was history of extrapulmonary tuberculosis in grandmother 2 years ago for which adequate treatment was taken. His CRP was 3.9 (normal <0.5), ESR 38 and total leucocyte count of 4410. Management included sending workup in the lines of 'pyrexia of unknown origin'. Investigations done for Dengue, malaria WIDAL, scrub typhus, EBV, brucella, leptospira and atypical pneumonia, auto immune workup all of which were negative. Ultrasound of left axilla and HRCT chest were suggestive of multiple enlarged non necrotic lymph nodes left axillary and pectoral plane. CECT abdomen, gastric lavage for AFB and CBNAAT done to rule out tuberculosis which were negative. In view of pyrexia of unknown origin doxycycline, azithromycin and chloroquine trial given but there was no response to fever. Finally lymph node biopsy was taken in which lymph 3 enlarged lobulated lymph nodes excised and were sent for TB CBNAAT, MGIT, gram staining and histopathology out of which histopathology was suggestive of Kikuchi Fujimoto disease. Post lymph node excision fever subsided immediately. Patient was started on oral naproxen. Hence it took a long battle to differentiate between uncommon infectious causes, tuberculosis and autoimmune causes finally to end with a rare diagnosis of Kikuchi Fujimoto disease which is usually uncommon at this age and gender.

Keywords: kikuchi fujimoto, lymph node, histiocytic necrotizing lymphadenitis, rare disease, pyrexia of unknown origin, lymph node biopsy

Edition: Volume 12 Issue 5, May 2023

Pages: 782 - 783

DOI: https://www.doi.org/10.21275/SR23509222947

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