SHM Converge Scientific Abstract ePoster Gallery-A Rare Cause of Fever With Lymphadenopathy: Kikuchi-Fujimoto Disease

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This case describes a 37-year-old woman from Ghana who presented with one week of myalgias, right-sided neck pain, and a newly noticed right anterior neck swelling. Examination showed a mobile, non-pulsatile cervical mass along the sternocleidomastoid. Initial infectious and autoimmune testing was negative, including strep, EBV, respiratory viral panel, ANA, and HIV, though inflammatory markers were elevated (ESR 47, CRP 10.7).<br /><br />CT imaging of the neck showed a cluster of mildly enlarged right anterior cervical lymph nodes with surrounding fat inflammation and sternocleidomastoid myositis, without any drainable abscess. She was started empirically on Unasyn while blood cultures and further workup were pursued. CT of the chest and abdomen showed no additional lymphadenopathy.<br /><br />An interventional radiology-guided lymph node biopsy revealed findings consistent with Kikuchi-Fujimoto lymphadenitis: necrotizing lymphadenitis with karyorrhectic debris, absence of neutrophils, and plasmacytoid dendritic cells. Cultures from the biopsy were negative for bacterial, fungal, and mycobacterial growth. Based on these results, antibiotics were stopped.<br /><br />The patient was discharged and improved clinically, with follow-up imaging six weeks later showing complete resolution of the lymphadenitis.<br /><br />The discussion highlights Kikuchi-Fujimoto disease (KFD) as a rare, usually self-limited cause of cervical lymphadenopathy and fever, most often affecting people under 40. Diagnosis relies on lymph node biopsy, and the condition can mimic lymphoma or autoimmune disease. Because it often resolves spontaneously, recognizing KFD early helps avoid unnecessary treatments and reduces patient anxiety.

Asset Subtitle

Sandhya Tagaram

Meta Tag

Author List Sandhya Tagaram, Shashidhar Reddy Madireddy

Category Clinical Vignettes

Concept Kikuchi-Fujimoto disease

Concept Cervical Lymphadenopathy

Concept Fever

Concept Muscle Pain

Concept Karyorrhectic Debris

Distinguished Non-Finalist

Presenter Organization UMass Memorial Medical Center

Presenting Author Sandhya Tagaram

Track Adult

Keywords

Kikuchi-Fujimoto disease

necrotizing lymphadenitis

cervical lymphadenopathy

right anterior neck swelling

sternocleidomastoid myositis

lymph node biopsy

karyorrhectic debris

plasmacytoid dendritic cells

self-limited disease

Ghana woman

Kikuchi-Fujimoto disease

Cervical Lymphadenopathy

Fever

Muscle Pain

Karyorrhectic Debris