Brucella melitensis infection stimulates an immune response leading to Kikuchi-Fujimoto disease

A 43-year-old Greek cattler with a history of brucellosis three months previously for which he was treated with sulfonamides for three weeks, was admitted to the hospital complaining of fever, arthralgias, night sweats, painful cervical and axillary lymph nodes as well as a weight loss of 8 kg in the previous four months. Since microbiological and serological studies did not give a specific diagnosis, an open cervical lymph node biopsy was performed. The histological examination revealed Kikuchi-Fujimoto disease. The etiology of the disease is unknown but viral, bacterial, protozoal and neoplastic as well as physicochemical agents may stimulate a particular immune response leading to Kikuchi-Fujimoto disease. Hereby, we present a case in which Kikuchi-Fujimoto disease followed brucella melitensis infection. This association permits us to hypothesize that the initial brucella melitensis infection three months previously triggered an immune response leading to Kikuchi-Fujimoto disease. The association of the disease with brucellosis is very important since these two entities share some similar characteristics, with brucellosis being relatively common in Europe. To our best knowledge, in the English language bibliography, this is the first reported case worldwide, though another similar case was described in the Spanish literature ten years ago.