Kikuchi-fujimoto disease in Rwanda: A rare disease with a common presentation

CASE PRESENTATION: We describe a 28-year-old female patient who presented at the Kigali University Teaching Hospital with a one-week history of right cervical lymphadenopathy, fever and headache. She later developed uveitis of the left eye. Her septic work-up was remarkable for aseptic meningitis. During the second week of her hospitalization, her symptoms resolved completely. Lymph node biopsy results were consistent with Kikuchi-Fujimoto disease (KFD). KFD, also known as histiocytic necrotizing lymphadenitis, is a rare and self-limiting disease. It is commonly seen in the young adult Asian population. Although its pathophysiology is not well understood, it is thought to be a result of an immune response of T cell histiocytes. KDF usually presents with unilateral lymphadenopathy and fever. The Diagnosis is made by histopathology of an involved lymph node. Symptoms usually resolve within 1 to 4 months. Aseptic meningitis and/or uveitis, though rare, can be part of KFD. In our current practice, we start patients on antituberculosis medications based on raised white blood cells in cerebrospinal fluid with lymphocytic predominance. However, it is very unlikely that all of them have tuberculous meningitis. CONCLUSION: KFD is a rare condition that presents like common conditions, such as tuberculosis and lymphoma. We underline the importance of pursuing pathological diagnosis, before starting a long and potentially harmful treatment.