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 anti-tuberculosis 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.