A 26-year-old woman presented with recurrent Kikuchi disease 7 years after her initial episode. Computed tomography (CT) and ultrasonography demonstrated enlarged lymph nodes with extensive necrosis at the same site as the initial episode. Cytologic and histologic examinations were not conclusive. CT performed 1 month later demonstrated a complete resolution of the lymphadenopathy, which confirmed the diagnosis of recurrent Kikuchi disease. Care must be taken to avoid misdiagnosis of recurrent Kikuchi disease as tuberculous lymphadenitis.
Kikuchi disease is a self-limited illness characterized by lymphadenitis, fever, and leukopenia. It most commonly affects women younger than 30 years of age, and it often resolves spontaneously. It is believed to be caused by an exaggerated T-cell response to external antigens, probably as a result of viral infection.1 Some authors have proposed the possibility that Epstein-Barr virus or human herpesvirus 6 are the causative pathogens.2,3