Kikuchi-Fujimoto disease or
histiocytic necrotizing lymphadenitis is a benign, rare,
self limitimg
disease presenting with mainly cervical
lymphadenopathy and
fever unresponsive to
antibiotics or medical
treatment. A 28-year old man presented with
fever and right lower quadrant
abdominal pain.
Physical examination showed abdominal tenderness and rebound tenderness mimicking acute
appendicitis. Imaging studies showed normal
appendix and other abdominal organs except enlarged multiple mesenteric
lymph nodes. Symptoms persisted despite antimicrobial
therapy. Multiple tender
lymph nodes were palpable on bilateral cervical area at the 7th
hospital day. The
biopsy of the
neck node showed large areas of patchy, irregular
necrosis with prominent nuclear debris surrounded by
T lymphocytes,
histiocytes without
neutrophils and
granuloma, so he was diagnosed as
Kikuchi-Fujimoto disease. With
conservative management, clinical improvement was observed. We suggest that
Kikuchi-Fujimoto disease with
mesenteric lymphadenitis should be added to the
differential diagnosis of
acute abdomen mimicking acute
appendicitis in
young adults.