Teaching Hospital Peradeniya, Peradeniya, Kandy, Sri Lanka.
J Med Case Rep. 2024 Jun 6;18(1):270. doi: 10.1186/s13256-024-04541-z.
Kikuchi Fujimoto disease is a rare self-limiting disorder mainly affecting young Asian females. The typical presentation is unexplained fever with associated cervical lymphadenopathy. It can mimic many sinister diseases such as lymphoma, tuberculosis, and systemic lupus erythematosus. Aseptic meningitis due to Kikuchi disease is extremely rare, and majority were reported from Japan. There have been no published cases of aseptic meningitis due to Kikuchi disease in Sri Lanka.
A 29 years old Sri Lankan female presented with a prolonged fever for three weeks with an associated headache for five days duration. She developed painful cervical lymphadenopathy during the hospital stay. She has been previously well and had been vaccinated against COVID-19 six weeks before. Her lumbar puncture showed lymphocytic pleocytosis with marginally elevated protein levels and reduced ratio of serum to CSF sugar. Lymph node biopsy was consistent with necrotizing lymphadenitis. She was subsequently diagnosed with Kikuchi disease complicated with aseptic meningitis. She responded to corticosteroids well and had an uneventful recovery.
Kikuchi disease is a rare self-limiting disorder that can be complicated with aseptic meningitis on infrequent occasions. Other conditions such as tuberculosis, lymphoma, systemic lupus erythematosus, and adult-onset Still's disease should be considered as differential diagnoses. Knowledge of Kikuchi disease and its complications will prevent unnecessary investigations which delay the early diagnosis and treatment.
Fujimoto 吉村病是一种罕见的自限性疾病，主要影响年轻的亚裔女性。其典型表现为原因不明的发热伴颈淋巴结病。它可以模仿许多恶性疾病，如淋巴瘤、结核病和系统性红斑狼疮。由吉村病引起的无菌性脑膜炎极为罕见，多数病例报告来自日本。斯里兰卡尚未有因吉村病引起无菌性脑膜炎的报道。
一名 29 岁的斯里兰卡女性因发热持续三周伴头痛五天入院。住院期间她出现了疼痛性颈淋巴结病。她既往健康，在六周前接种了 COVID-19 疫苗。她的腰椎穿刺显示淋巴细胞增多症，蛋白水平略有升高，血清与脑脊液糖的比值降低。淋巴结活检符合坏死性淋巴结炎。随后诊断为吉村病并发无菌性脑膜炎。她对皮质类固醇反应良好，恢复顺利。
Fujimoto 吉村病是一种罕见的自限性疾病，偶尔会并发无菌性脑膜炎。其他疾病如结核病、淋巴瘤、系统性红斑狼疮和成人Still 病等应作为鉴别诊断。了解吉村病及其并发症可避免不必要的检查，从而避免延误早期诊断和治疗。
