Histiocytic Necrotizing Lymphadenitis: A Case Report

Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is an inflammatory rare benign disorder, involving young patients. It predominantly occurs in females younger than 40 years of age. Moreover, it is characterized by fever and
lymphadenopathy. Lymphadenopathy is usually located in the cervical area, and the nodes are mostly unilateral and tender. Fever is present in one third of cases. Skin lesions, arthralgia, myalgia,splenomegaly, or hepatomegaly are rare.
There are no particular laboratory tests for this disease; however, its evaluation shows a slight increase of erythrocyte sedimentation rate and leukopenia. Although viruses and autoimmune mechanisms have been suggested, the etiology is still unknown. Because the laboratory data are often normal and lymphoma and systemic lupus erythematosus (SLE) should be ruled out, diagnosis is fundamentally based on the affected lymph node biopsy. Spontaneous recovery of the disorder occurs within several weeks to months.
Our patient is a 34 years old female. In August 2015, she presented without any history of fever, chills, rash, and loss of weight associated with right cervical submandibular lymphadenopathy and earache. Laboratory data were normal other than a slight increase of ESR and CRP. Finally, as malignancy was still a strong possibility, a cervical lymph node biopsy was performed and necrotizing lymphadenitis was diagnosed. Subsequently, she was treated with steroids and lymph nodes were reduced; however, within 1 month it recurred. Finally, with possible diagnosis of human herpes virus through administration of acyclovir, the patient’s lymphadenopathy completely disappeared, and it did not recur within 6 months.