Sohail Sabir, Hafeezuddin, Tariq Khan.
Kikuchui- fujimoto disease.
Pak Armed Forces Med J Jan ;59(4):307-8.

Kikuchi's disease first described in 1972 by Kikuchi and Fujimoto et al usually manifests as a localized cervical adenopathy, primarily in the posterior neck of young women [1]. Its course is benign, but can be misdiagnosed as lymphoma,A 29-year-old woman presented with a history of fever and multiple swellings over both sides of neck for last one month. She was evaluated initially in a different hospital and considering the high local prevelance of tuberculosis underwent excisional lymph node biopsy of right cervical lymph nodes which revealed chronic nonspecific inflammation. However postoperatively on third day she developed swelling over the biopsy site with purulent discharge and high grade fever accompanied by rigors and chills. Mantoux test was negative as were tests for human immunodeficiency virus and brucellosis. Her angiotensin-converting enzyme level was normal. Her antinuclear antibody (ANA) screen was negative. Pus swab from the biopsy site revealed staphylococcus aureus sensitive to Flucloxacillin. Findings on chest x-ray were interpreted as normal. Patient started improving within a week.The swelling subsided and purulent discharge stopped. However she continued to have low grade evening fever with night sweats. After two weeks an excisional biopsy of cervical lymph node from the left side was done. Histopathology report revealed partial effacement of the lymph node architecture with focal cortical and paracortical areas of karyorrhexis and karyolysis. Many histiocytic cells with peripherally placed crescentic nuclei were also seen. Ziehl Neelsen stain and Periodic acid Schiff stains failed to demonstrate acid fast bacilli and fungi respectively. Based on these findings a diagnosis of Kikuchi Fujimotos disease was formulated (Fig. 1 & 2). both clinically and pathologically [2].

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