Vol.99 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 5 May 2006
A Case of Kikuchi's Disease with Cervical
Lymph Node Swelling and High Fever
Yoshifumi Yamamoto
(Toyonaka Municipal Hospital)
Tadashi Kitahara and Takeshi Kubo
(Osaka University)
Cervical lymph node swelling and high fever are common in patients presenting to the Department of Otolaryngology. Kikuchi's disease is an idiopathic necrotizing histiocyte lymphadenitis with the main clinical feature being adenopathy, generally in a cervical location. The disease is relatively rare and often misdiagnosed as lymphoma or lupus and inappropriately treated, potentially causing numerous medical consultations without relief of symptoms. The case described is that of a 28-year-old female with persistent cervical lymphadenitis and fever who presented to our department without an appropriate diagnosis at previous hospitals. All symptoms were quite resistant to antibiotics or NSAIDs. Laboratory results showed WBC decrease and AST/ALT increase, although common viral infectious diseases were denied. Finally, left cervical lymph node biopsy was performed under local anesthesia and the patient was diagnosed as having histiocytic necrotizing lymphadenitis or Kikuchi's disease. Since Kikuchi's disease is sometimes recurrent and coupled with collagen disease, long-term follow-up should be required.
Key words : cervical lymph node swelling, fever, histiocytic necrotizing lymphadenitis, malignant
lymphoma, collagen disease