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Kikuchi-Fujimoto disease concurrent with aseptic meningitis or encephalitis in children: a case-control study

Bing Liu1, Yi Sun1, Bing Hu1

  • 1Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, National Center for Children's Infectious and Allergic Diseases Surveillance, Beijing Research Center for Respiratory Infectious Diseases, Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Key Laboratory of Major Diseases in Children, Ministry of Education, No. 56 Nan Lishi Road, Beijing, 100045, China.

BMC Pediatrics
|April 12, 2025
PubMed

Insights

Kikuchi-Fujimoto disease in children can involve the central nervous system, presenting with symptoms like fever and headache. Consider Kikuchi-Fujimoto disease in children with aseptic meningitis or encephalitis, especially with swollen lymph nodes.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Rheumatology

Background:

  • Kikuchi-Fujimoto disease (KFD) is a rare, self-limiting disorder.
  • Central nervous system (CNS) involvement in pediatric KFD is uncommon but serious.
  • This study focuses on KFD concurrent with aseptic meningitis or encephalitis in children.

Purpose of the Study:

  • To summarize the clinical and laboratory features of pediatric KFD with CNS involvement.
  • To identify characteristics associated with aseptic meningitis or encephalitis in KFD patients.
  • To aid in the differential diagnosis of CNS infections in children.

Main Methods:

  • A case-control study was conducted.
  • Data from 64 pediatric KFD cases (16 with CNS involvement, 48 controls) were analyzed.
  • Clinical and laboratory findings were compared between groups.

Main Results:

  • The 16 CNS-involved cases had a median age of 8 years, with fever and cervical lymph node tenderness being common.
  • Leukoencephalopathy was observed in 11 cases on head imaging.
  • Cervical lymph node tenderness, headache, confusion, convulsions, elevated C-reactive protein, and elevated lactate dehydrogenase were significantly associated with CNS involvement.

Conclusions:

  • Pediatric KFD patients with cervical lymph node tenderness, elevated C-reactive protein, or elevated lactate dehydrogenase require evaluation for CNS involvement.
  • Kikuchi-Fujimoto disease should be considered in the differential diagnosis for children presenting with aseptic meningitis or encephalitis.
Abstract

Keywords:
ChildHistiocytic necrotizing lymphadenitisMeningitis and encephalitis

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