Pyrexia With Pancytopenia: An Uncommon Presentation of Kikuchi Disease

Kikuchi-Fujimoto disease is a rare systemic illness commonly affecting young females with a higher tendency to occur in the Asian population. Clinical presentation varies with most patients presenting with fever and cervical lymphadenopathy. The patient discussed in this case report presented to a tertiary care hospital in Sri Lanka with a fever for two weeks and palpable cervical lymphadenopathy. She was extensively evaluated as a case of pyrexia of unknown origin and failed to detect any significant abnormality except pancytopenia, which is a rarely associated hematological manifestation. The diagnosis was confirmed by cervical lymph node excision biopsy, which showed typical features to suggest Kikuchi disease. She was treated accordingly with steroids, resulting in a complete resolution of symptoms. This is a rare clinical entity that may give rise to diagnostic difficulty due to its rarity as well as the uncommon associations with pancytopenia. Further, though Kikuchi disease is commonly self-limiting, it may mimic many sinister pathologies, which warrant their exclusion.