Histiocytic Necrotizing Lymphadenitis

We are presenting a case of histiocytic necrotizing lymphadenitis (Kikuchi disease), which is characterized by involvement of lymph nodes, skin, liver and spleen. A 21-year-old girl presented with 27 days history of prolonged fever, left cervical painless lymphadenitis and maculo-papular skin rashes. Lab investigations revealed leucopenia (TLC 2700/cumm) with neutropenia, raised S.LDH-1470, ESR −30–70mm, raised AST- 71, ALT-81, HIV I & II, Heterophil antibody for infectious mononucleosis, H. simplex I & II serology, ANA, Rh factor, P-ANCA, C-ANCA were non-reactive. Bone marrow aspiration, biopsy, Aerobic & AFB C/S were negative, FNAC of cervical lymph nodes was reactive. Lymph nodes biopsy confirmed the diagnosis. She became afebrile within nine days of discharge and lymph nodes disappeared within two months. This case is being presented because of the rarity of this disease, in the setting of fever with lymphadenitis.