Infect Chemother.  2006 Oct;38(5):304-307.

A Case of Kikuchi-Fujimoto Disease Presenting as Mesenteric Lymphadenitis

• Choi WS
• Lee SS
• Kwon CW
• Lee YS
• Kim SY
• Cheon SY
• Kim MJ
• Chung DR

Abstract

Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a benign, rare, self limitimg disease presenting with mainly cervical lymphadenopathy and fever unresponsive to antibiotics or medical treatment. A 28-year old man presented with fever and right lower quadrant abdominal pain. Physical examination showed abdominal tenderness and rebound tenderness mimicking acute appendicitis. Imaging studies showed normal appendix and other abdominal organs except enlarged multiple mesenteric lymph nodes. Symptoms persisted despite antimicrobial therapy. Multiple tender lymph nodes were palpable on bilateral cervical area at the 7th hospital day. The biopsy of the neck node showed large areas of patchy, irregular necrosis with prominent nuclear debris surrounded by T lymphocytes, histiocytes without neutrophils and granuloma, so he was diagnosed as Kikuchi-Fujimoto disease. With conservative management, clinical improvement was observed. We suggest that Kikuchi-Fujimoto disease with mesenteric lymphadenitis should be added to the differential diagnosis of acute abdomen mimicking acute appendicitis in young adults.

Keyword

Kikuchi-Fujimoto disease; Histiocytic necrotizing lymphadenitis; Mesenteric lymphadenitis

MeSH Terms

Abdomen, Acute
Abdominal Pain
Adult
Anti-Bacterial Agents
Appendicitis
Appendix
Biopsy
Diagnosis, Differential
Fever
Granuloma
Histiocytes
Histiocytic Necrotizing Lymphadenitis*
Humans
Lymph Nodes
Lymphatic Diseases
Mesenteric Lymphadenitis*
Neck
Necrosis
Neutrophils
Physical Examination
T-Lymphocytes
Young Adult
Anti-Bacterial Agents