Department of Infectious Diseases, Kyoto City Hospital, Japan.
Department of Neurology, Kyoto City Hospital, Japan.
Intern Med. 2022 Sep 1;61(17):2687-2689. doi: 10.2169/internalmedicine.7724-21. Epub 2022 Feb 19.
Kikuchi disease, also called histiocytic necrotizing lymphadenitis, is an idiopathic and generally self-limiting disease affecting young adults and children. Kikuchi disease does not commonly manifest neurological complications at its initial presentation. We herein report two cases of Kikuchi disease that initially presented with aseptic meningitis and encephalitis rather than the more common signs of lymphadenopathy, rash, and arthritis. A 15-year-old boy presented with aseptic meningitis with an extremely high intracranial pressure. A 28-year-old man presented with dysesthesia of the right lower extremity, coinciding with abnormal magnetic resonance imaging findings. In both cases, painful cervical lymphadenopathy was observed following the central nervous system symptoms. Both patients improved after treatment with steroids. Kikuchi disease occasionally affects the central nervous system, to which lymphadenitis may be observed subsequently. A repeated, careful physical examination of the cervical lymph nodes may be helpful for the diagnosis.
菊池病，也称组织细胞坏死性淋巴结炎，是一种特发性、通常自限性疾病，好发于青年和儿童。菊池病初次发病时通常不伴有神经并发症。本文报告两例以无菌性脑膜炎和脑炎为初始表现，而非更常见的淋巴结病、皮疹和关节炎为表现的菊池病。例 1 为 15 岁男孩，表现为伴有极高颅内压的无菌性脑膜炎；例 2 为 28 岁男性，表现为右下肢感觉异常，同时伴有磁共振成像异常。在这两例患者中，均在出现中枢神经系统症状后出现疼痛性颈淋巴结肿大。两例患者均经类固醇治疗后好转。菊池病偶尔累及中枢神经系统，随后可能观察到淋巴结炎。反复、仔细的颈淋巴结体格检查有助于诊断。
