To the Editor: Kikuchi–Fujimoto disease (KFD) was described in 1972 by Kikuchi and Fujimoto. KFD is a benign, self-limited lymphadenitis consisting of lymphadenopathy, fever, skin rashes, arthralgia, and hepatosplenomegaly, along with elevated levels of ESR, CRP, and LDH, lymphopenia, thrombocytopenia, and leukocytosis. The various etiologies include viral infections and autoimmune diseases and recently, associations between COVID-19 and KFD were also reported. We discuss a case of KFD 6 wk after COVID-19 in a 10-y-old girl who was admitted with high-grade fever since 3 wk, bilateral, tender neck swelling, and macular rash off and on all over the body and face. There are very few case reports of associations between KFD and COVID-19 in the literature [1–3]. All the cases presented with fever and cervical lymphadenopathy within 2–3 mo of COVID infection. Our patient had leukopenia, anemia, and a raised ESR, similar to the cases described in the literature. All cases had raised LDH, including ours.
There is no specific diagnostic test for KFD. It is a diagnosis of exclusion. The diagnosis can be made only by histological examination of the involved lymph node and is characterized by a noncaseating necrotic area, karyorrhectic nuclear debris surrounded by mononuclear cells, particularly CD68+ histiocytes, CD123+ plasmacytoid dendritic cells, and activated CD8+ T-lymphocytes. There is no specific treatment for KFD.
We report this case to highlight this sequalae of SARS-COVID infection which will help in early diagnosis and the management of KFD.
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References
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