Samuel D Racette1, Borislav A Alexiev2, Michael P Angarone3, Ajay Bhasin4,5, Kaitlin Lima6, Lawrence J Jennings2, Senthil Balasubramanian7, Akihiro J Matsuoka8,9,10. 1. Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair Street, Suite 1325, Chicago, IL, 60611, USA. samuel.racette@northwestern.edu. 2. Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 3. Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 4. Department of Medicine, Division of Hospital Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 5. Department of Pediatrics, Division of Hospital Based Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 6. Department of Medicine, Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 7. NorthShore University Health System, Evanston, IL, 60201, USA. 8. Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair Street, Suite 1325, Chicago, IL, 60611, USA. 9. Roxelyn and Richard Pepper Department of Communication Science Disorders, School of Communication, Northwestern University, Evanston, IL, 60208, USA. 10. Hugh-Knowles Hearing Center, Evanston, IL, 60208, USA.
Abstract
BACKGROUND: We present a yet to be described association of SARS-CoV-2 infection with Kikuchi-Fujimoto disease. CASE PRESENTATION: A 32-year-old physician with history of SARS-CoV-2 infection presented to the emergency department with 2 weeks of fever, chills, and right sided cervical lymphadenopathy. He was treated empirically for presumed folliculitis with worsening of symptoms leading to repeat presentation to the emergency department. Extensive workup was unrevealing of an infectious cause and needle biopsy of the lesion was unrevealing. An excisional lymph node biopsy revealed follicular hyperplasia with necrotic foci showing abundance of histiocytes at the edge of necrosis with CD8 predominance of T-cells. Final diagnosis was deemed to be Kikuchi-Fujimoto disease. Antibiotic therapy was discontinued, and the patient's symptoms resolved with steroid therapy and expectant management. CONCLUSIONS: This is the first report of a patient developing Kikuchi-Fujimoto disease following SARS-CoV-2 infection. Clinicians should be aware of Kikuchi-Fujimoto disease as a possibility when approaching patients with hyper-inflammatory states who present with cervical lymphadenopathy.
BACKGROUND: We present a yet to be described association of SARS-CoV-2 infection with Kikuchi-Fujimoto disease. CASE PRESENTATION: A 32-year-old physician with history of SARS-CoV-2 infection presented to the emergency department with 2 weeks of fever, chills, and right sided cervical lymphadenopathy. He was treated empirically for presumed folliculitis with worsening of symptoms leading to repeat presentation to the emergency department. Extensive workup was unrevealing of an infectious cause and needle biopsy of the lesion was unrevealing. An excisional lymph node biopsy revealed follicular hyperplasia with necrotic foci showing abundance of histiocytes at the edge of necrosis with CD8 predominance of T-cells. Final diagnosis was deemed to be Kikuchi-Fujimoto disease. Antibiotic therapy was discontinued, and the patient's symptoms resolved with steroid therapy and expectant management. CONCLUSIONS: This is the first report of a patient developing Kikuchi-Fujimoto disease following SARS-CoV-2 infection. Clinicians should be aware of Kikuchi-Fujimoto disease as a possibility when approaching patients with hyper-inflammatory states who present with cervical lymphadenopathy.
Authors: Yanchun Peng; Alexander J Mentzer; Guihai Liu; Xuan Yao; Zixi Yin; Danning Dong; Wanwisa Dejnirattisai; Timothy Rostron; Piyada Supasa; Chang Liu; César López-Camacho; Jose Slon-Campos; Yuguang Zhao; David I Stuart; Guido C Paesen; Jonathan M Grimes; Alfred A Antson; Oliver W Bayfield; Dorothy E D P Hawkins; De-Sheng Ker; Beibei Wang; Lance Turtle; Krishanthi Subramaniam; Paul Thomson; Ping Zhang; Christina Dold; Jeremy Ratcliff; Peter Simmonds; Thushan de Silva; Paul Sopp; Dannielle Wellington; Ushani Rajapaksa; Yi-Ling Chen; Mariolina Salio; Giorgio Napolitani; Wayne Paes; Persephone Borrow; Benedikt M Kessler; Jeremy W Fry; Nikolai F Schwabe; Malcolm G Semple; J Kenneth Baillie; Shona C Moore; Peter J M Openshaw; M Azim Ansari; Susanna Dunachie; Eleanor Barnes; John Frater; Georgina Kerr; Philip Goulder; Teresa Lockett; Robert Levin; Yonghong Zhang; Ronghua Jing; Ling-Pei Ho; Richard J Cornall; Christopher P Conlon; Paul Klenerman; Gavin R Screaton; Juthathip Mongkolsapaya; Andrew McMichael; Julian C Knight; Graham Ogg; Tao Dong Journal: Nat Immunol Date: 2020-09-04 Impact factor: 25.606
Authors: Hussain A Al Ghadeer; Sajjad M AlKadhem; Mohammed S AlMajed; Hassan M AlAmer; Jaber A AlHabeeb; Suad H Alomran; Abdullah S AlMajed Journal: Cureus Date: 2022-01-09