SHM Converge Scientific Abstract ePoster Gallery-Kikuchi-Fujimoto Disease: An Underrecognized Cause of Lymphadenopathy in Young Women

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Kikuchi-Fujimoto disease is a rare, self-limited cause of lymphadenopathy that is often underrecognized, especially in young women. This case describes a 22-year-old woman with no significant past medical history who developed 4 days of progressive symptoms including fever, night sweats, painful left neck swelling, decreased appetite, lightheadedness, and left orbital headache. On arrival she was febrile and tachycardic, with tender, matted supraclavicular and anterior cervical lymphadenopathy.<br /><br />Laboratory findings showed leukopenia, elevated ESR, and markedly elevated CRP. CT of the neck demonstrated extensive left-sided cystic and necrotic lymphadenopathy with surrounding inflammatory changes and free fluid. An extensive infectious, autoimmune, and hematologic workup was negative, including testing for common viral, bacterial, fungal, and inflammatory causes as well as evaluation for malignancy. Core lymph node biopsy revealed necrotizing lymphadenitis with abundant histiocytes and scant neutrophils, consistent with Kikuchi-Fujimoto disease.<br /><br />The disease is thought to have genetic, viral, autoimmune, or idiopathic triggers. Clinically, it typically presents with fever, fatigue, night sweats, painful lymphadenopathy, and sometimes skin rash, most commonly in women aged 20 to 30 years, particularly those of East Asian descent. Diagnosis relies on lymph node biopsy. Treatment is usually supportive, with NSAIDs for pain and corticosteroids in more severe cases; most patients recover within 1 to 4 weeks.<br /><br />The key clinical lesson is that Kikuchi-Fujimoto disease should be included in the differential diagnosis of lymphadenopathy, particularly when young women present with fever and cervical node enlargement and initial infectious or malignant evaluations are unrevealing.

Asset Subtitle

Ryan C. Crane

Meta Tag

Author List Benjamin Busman, Eiman Elhouderi, Ryan C. Crane

Category Clinical Vignettes

Concept Kikuchi-Fujimoto disease

Concept Lymphadenopathy

Concept Cervical Lymphadenopathy

Concept Lymph Node Biopsy

Concept Fever

Distinguished Non-Finalist

Presenter Organization Corewell Health West/Michigan State University

Presenting Author Ryan C. Crane

Track Adult

Keywords

Kikuchi-Fujimoto disease

lymphadenopathy

necrotizing lymphadenitis

cervical lymph nodes

fever

young women

histiocytes

leukopenia

lymph node biopsy

self-limited disease

Kikuchi-Fujimoto disease

Lymphadenopathy

Cervical Lymphadenopathy

Lymph Node Biopsy

Fever