Kikuchi-Fujimoto Disease Mimicking Tuberculosis

Madiha Mahfoudhi^*, Imen Gorsane, Sami Turki, Taieb Ben Abdallah

Department of Internal Medicine A, Charles Nicolle Hospital, Tunis, Tunisia.

DOI: 10.4236/ijcm.2015.610096                

Abstract

A 32-year-old woman presented with a fever and cervical lymphadenopathies. The research for Mycobacterium tuberculosis was negative. Tuberculin skin test was positive. Laboratory investigations showed an elevated erythrocyte sedimentation rate and a normal white blood cell count. Bacteriological and viral investigations were negative. Quantiferon-Tb Gold test was indeterminate. Thraco-abdominal and pelvic computed tomography, FDG-PET and gallium scintigraphy revealed no abnormalities. Histological study of cervical lymph node biopsy found signs in favor of histiocytic necrotizing lymphadenitis. There were no epithelioid cell granulomas. A test tuberculosis treatment was refused by the patient. The evolution was marked by spontaneous clinical and biological resolution in fifty days. The negative Lowenstein-Jensen culture eliminated formally the tuberculosis. KFD was thus the most likely diagnosis.

Keywords

Kikuchi-Fujimoto Disease, Mycobacterium tuberculosis, Lymphadenitis, Histology

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Kikuchi, M. (1972) Lymphadenitis Showing Focal Reticulum Cell Hyperplasia with Nuclear Debris and Phagocytosis. Nippon Ketsueki Gakkai Zasshi, 35, 379-380.
[2]	Fujimoto, Y., Kozima, Y. and Yamaguchi, K. (1972) Cervical Subacute Necrotizing Lymphadenitis: A New Clinicopathological Entity. Naika, 30, 920-927.
[3]	Xavier, R.G., Silva, D.R., Keiserman, M.W. and Lopes, M.F. (2008) Kikuchi-Fujimoto Disease. Jornal Brasileiro de Pneumologia, 34, 1074-1078. http://dx.doi.org/10.1590/S1806-37132008001200014
[4]	Nakamura, I., Imamura, A., Yanagisawa, N., Suganuma, A. and Ajisawa, A. (2009) Medical Study of 69 Cases Diagnosed as Kikuchi’s Disease. Kansenshogaku Zasshi, 83, 363-368.
[5]	Bosch, X., Guilabert, A., Miquel, R. and Campo, E. (2004) Enigmatic Kikuchi-Fujimoto Disease: A Com-prehensive Review. American Journal of Clinical Pathology, 122, 141-152. http://dx.doi.org/10.1309/YF081L4TKYWVYVPQ
[6]	Kurahara, Y., Tachibana, K., Tezuka, K., Shimizu, S., Kitaichi, M., Hayashi, S., et al. (2012) Kikuchi-Fujimoto Disease Mimicking Tuberculous Lymphadenitis. Internal Medicine, 51, 1927-1930. http://dx.doi.org/10.2169/internalmedicine.51.7574
[7]	Nayak, H.K., Mohanty, P.K., Mallick, S. and Bagchi, A. (2013) Diagnostic Dilemma: Kikuchi’s Disease or Tuberculosis? BMJ Case Reports, 2013. http://dx.doi.org/10.1136/bcr-2012-008026
[8]	Kamath, M.P., Bhojwani, K., Naik, R., Kumar, R. and Chakravarthy, Y. (2006) Tuberculosis Mimicking Kikuchi’s Disease. Ear, Nose & Throat Journal, 85, 126-128.
[9]	el-Ramahi, K.M., Karrar, A. and Ah, M.A. (1994) Kikuchi Disease and Its Association with Systemic Lupus Erythematosus. Lupus, 3, 409-411. http://dx.doi.org/10.1177/096120339400300508
[10]	Sanpavat, A., Wannakrairot, P. and Assanasen, T. (2006) Necrotizing Non-Granulomatous Lymphadenitis: A Clinicopathologic Study of 40 Thai Patients. Southeast Asian Journal of Tropical Medicine and Public Health, 37, 563-570.