Wong Yu Kwong, Khan Marium
General Medicine, Queen's Medical Centre, Nottingham, UK.
Department of Histopathology, Queen's Medical Centre, Nottingham, UK.
BMJ Case Rep. 2018 Aug 10;2018:bcr-2018-225210. doi: 10.1136/bcr-2018-225210.
A 28-year-old Pakistani man with previously treated latent tuberculosis (TB) presented with a 3-month history of productive cough, fever, drenching night sweats, anorexia, sore throat and tender left cervical lymphadenopathy. Extensive biochemical and microbiological tests, and imaging studies were all inconclusive. Lymph node biopsy revealed the diagnosis of Kikuchi-Fujimoto disease (KFD). He had persistent fever and anorexia during admission despite supportive measures which resolved quickly on starting prednisolone. He remained well after being weaned off steroids on 18 weeks' follow-up. KFD is a rare, self-limiting disease which can mimic several serious conditions such as TB and lymphoma. Prompt diagnosis with lymph node biopsy is paramount in addressing diagnostic uncertainty and avoids starting potentially toxic treatment on these patients.
一名28岁曾接受过潜伏性结核病治疗的巴基斯坦男子,出现了3个月的咳痰、发热、盗汗、厌食、咽痛及左侧颈部淋巴结压痛病史。广泛的生化及微生物学检查以及影像学检查均无定论。淋巴结活检确诊为菊池-藤本病(KFD)。尽管采取了支持性措施,但他在住院期间仍持续发热和厌食,开始使用泼尼松龙后症状迅速缓解。在18周的随访中,停用类固醇后他恢复良好。KFD是一种罕见的自限性疾病,可模仿多种严重疾病,如结核病和淋巴瘤。通过淋巴结活检进行快速诊断对于解决诊断不确定性至关重要,可避免对这些患者开始使用可能有毒的治疗。