Kikuchi-Fujimoto's Disease in a Pediatric Patient with Mycobacterium tuberculosis Infection

Kikuchi-Fujimoto's disease (KFD), alternatively termed histiocytic necrotizing lymphadenitis, was first described in 1972. KFD is rare in children, with most of the cases occurring between the ages of 20 and 30 years with a female-to-male ratio of 4:1. The etiology is unknown, although infectious and autoimmune mechanisms have been proposed. KFD manifests with a spectrum of nonspecific clinical symptoms and laboratory findings. KFD is without a definitive diagnostic test and is a diagnosis of exclusion, which must be differentiated from other disease processes with associated lymphadenopathy. Significant overlap in both clinical presentation and histological features with other diseases, such as non-Hodgkin lymphoma, systemic lupus erythematosus, and active tuberculosis (TB), presents challenges in diagnosis. A small number of case reports have been published describing the coexistence of KFD and active TB. Most reported cases occur in TB endemic areas. In the largest analysis of KFD, TB infection was concurrent in 2% of cases. Most of the cases occurred in adult patients. To our knowledge, there have been no pediatric cases of KFD with concurrent TB infection reported in the United States. This study describes a case of KFD with concurrent Mycobacterium tuberculosis infection in a young male from the United States.