Nieves PCA, Morales MV, Francés FE, Gallegos GAC, Castro QÓ, Hurtado MR

Language: Spanish
References: 18
Page: 47-51
PDF size: 252.81 Kb.

ABSTRACT

Kikuchi's disease, also known as histiocytic necrotizing lymphadenitis, is a rare cause of more frequent lymphadenitis in the East. It is a self-limiting disease characterized by lymphadenopathy accompanied by symptoms such as fever, weight loss, asthenia, adynamia, and leukopenia. Recurrence of Kikuchi's disease is uncommon, but it will present with extranodal symptoms. We inform the case of a 27-year-old patient with a medical history of smoking (18 pack-years), cholecystectomy, Kikuchi-Fujimoto disease in the cervical lymph node, Gilbert's syndrome, and a mild COVID-19 infection two months prior to admission. She began with a fever of 39.2 °C, diaphoresis, non-productive cough, dyspnea, nasal discharge, and neck pain. She self-medicated with anti-inflammatory drugs without improvement, so she sought medical evaluation. On examination, she exhibited hypotension, tachycardia, diaphoresis, and 88% oxygen saturation, prompting hospitalization. The autoimmune profile and Epstein-Barr infection antibodies were adverse as part of the approach. Positron emission tomography-computed tomography (PET/CT) scan revealed hypermetabolic activity in Waldeyer's ring and cervical lymph nodes without evidence of bone marrow or splenic involvement. Subsequently, adenoidal biopsy and excision of the right cervical lymph node were performed. Pathological analysis indicated lymphocytic infiltration, abundant macrophages, histiocytosis, areas of necrosis, and karyorrhexis, suggestive of a recurrence of Kikuchi's disease.

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