Pervaiz Rashid, Muhammad Afzal.
Kikuchi`s disease.
Pak Armed Forces Med J Jan ;53(1):111-3.

A 40 year old female presented with 10 days history of high grade fever, progressive pallor, body aches, joint pains and small swelling in right cervical region. She had prolonged (over 10 years) history of chronic gastritis and had been on intermittent courses of antacids along with ulcer healing drugs. At the time of presentation, examination revealed an average build, pale lady with low-grade pyrexia (Temp 99.6°F) and right cervical lymphadenopathy. The lymphnodes were lcm to 2cm in size, tender and not matted. Rest of the physical examination was normal. Considering low grade pyrexia and tender cervical lymphadenopathy she was advised Co-Amoxiclav (Augmentin). On investigations her Hb was 10 Gm /dl, TLC 6800 & ESR 10mm. Her Urine RE, LFTs and X-ray chest were normal. Antinuclear antibodies, Antibrucella antibodies, RA factor and Monospot test were negative. FNA of cervical lymphnode was done twice but inconclusive so lymphnode biopsy of above mentioned region was performed which revealed histiocytic necrotizing lymphadenitis (Kikuchi`s disease). Co-Amoxiclav (Augmentin) was stopped after seven days and she was discharged from hospital with symptomatic improvement. Within two weeks she became afebrile and lymphadenopathy vanished. Since then she is symptom-free and doing well.

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