ABSTRACT
Kikuchi-Fujimoto disease (KFD) is a self-limiting disease of idiopathic origin affecting young women characterized by unexplained fever and lymphadenopathy. It has been usually found to be associated with autoimmunity, of which systemic lupus erythematosus (SLE) is the most outstanding. Fever and lymphadenopathy carry a broad differential, and a missed diagnosis of a rare condition such as Kikuchi can lead to inappropriate treatment in an otherwise benign condition. Therefore, careful examination and histologic confirmation of the diagnosis are critical.
ABSTRACT
Scrub typhus has a variety of clinical presentations ranging from asymptomatic to fever with chills, myalgias, hepatitis, gastric ulcerations and pancreatitis, all being attributed to disseminated vasculitis, with splenic infarction being a rare presentation. A 26-year man, a resident of north India, presented with an acute febrile illness and abdominal pain, computed tomography scan of the abdomen was suggestive of a splenic infarct. After ruling out other aetiology, a positive IgM (ELISA) for scrub typhus led to treatment with oral doxycycline, following which the patient was discharged symptom-free. Rarely can splenic infarction be attributable to scrub typhus; so far, five such cases have been reported in the published literature.
