Abstract
Introduction:
Kikuchi Fujimoto’s disease, known as histiocytic necrotizing lymphadenitis, a rare disorder that commonly affects young females, is a benign, self limiting condition. The prime cause may be infection, mostly being viral or autoimmune but the exact mechanism remains unclear. This case is challenging because of the misconception and misdiagnosis in view of the nonspecific clinical features leading to delay in treatment.
Case Report:
We report a case of a 24 year old pregnant female who had low grade fever, non tender cervical lymphadenopathy, dry cough followed by Gestational diabetes, polyhydramnios and premature rupture of membranes . Following this, she had spontaneous onset of labor in 35 weeks+6 days along with high grade fever and successfully delivered a male baby vaginally. Baby was healthy and breastfeeding except for the rashes in the anterior chest. Both mother and the baby were treated with antibiotics but low grade fever persisted in the mother even with anti-pyretics. Her symptoms started worsening with development of photosensitivity, difficulty in speech, progressive blurring of vision. After consent, medical examinations, laboratory analysis and radiological investigations were carried out to evaluate the alarming diagnoses of systemic lupus erythematosus, neoplastic lymph node diseases, cat scratch disease, toxoplasmosis, tuberculous lymphadenitis and viral etiology. The fine needle aspiration cytology and excisional biopsy report demonstrated a non-malignant chain of necrotizing lymphadenitis, accordingly Kikuchi-Fujimoto's disease probably due to Epstein-Barr virus was diagnosed. The patient was managed supportively with non-steroidal anti-inflammatory drugs and steroids.
Conclusion:
The summary of this report is to help the medical professionals to have better understanding about the nonspecific clinical features and in accurate diagnosis of the rare disorders especially in pregnancy. The primary aim is to prevent unnecessary interventions and systemic involvement . Also management should be directed in treating the contacts.
