Kikuchi-Fujimoto Disease: A Rare Aetiology Behind Pediatric Cervical and Supraclavicular Lymphadenopathy

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Background: Cervical lymphadenopathy is a common condition in children. The most frequent cause is reactive hyperplasia due to viral infections, followed by bacterial infections and, rarely, malignancies. Supraclavicular lymphadenopathy in children warrants careful evaluation due to its higher risk of malignancy compared to anterior cervical lymphadenopathy. Kikuchi-Fujimoto disease (KFD) is a rare, benign, self-limiting condition characterised by cervical lymphadenopathy, primarily affecting young adults, especially young Asian women, less often observed in children. Here, we present the case of a 14-year-old girl with cervical lymphadenopathy, with Kiku-chi-Fujimoto disease. Case presentation: A previously healthy 14-year-old girl was admitted to our hospital’s Pediatric Department with a 20-day history of cervical and supraclavicular lymphadenopathy, fever, and 5 kg weight loss. An extensive work-up revealed leucopenia & lymphopenia, along with a weak titer of ANA (1:160) and no other notable findings. Tests for viruses or microbes were negative. The cervical ultrasound revealed multiple, swollen, hypoechoic and rounded lymph nodes. CT of the thorax and abdomen showed paraaortic lymph nodes without other abnormal findings. Due to the persistence of the clinical picture, imaging findings, and negative results from an extensive diagnostic workup, and the lack of specific findings, a lymph node biopsy was performed to exclude malignancy, revealing findings consistent with KFD. Conclusion: We present a pediatric case of KFD, a very rare condition in children. This case emphasises the importance of considering a broad spectrum of potential diagnoses, including Kikuchi-Fujimoto disease, as persistent severe peripheral lymphadenopathy of unclear aetiology is identified.

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