Kikuchi-Fujimoto disease associated with community acquired pneumonia showing intrathoratic lymphadenopathy without cervical lesionsReportar como inadecuado




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SpringerPlus

, 4:693

Medicine

Abstract

IntroductionKikuchi-Fujimoto disease KFD, or histiocytic necrotizing lymphadenitis, is a rare entity of unknown etiology in young adults that is typically characterized by cervical lymphadenopathy and persistent fever. The pathogenesis of KFD has been suggested to be an abnormal immune response, and infections or autoimmune diseases are considered to be involved in KFD. However, KFD associated with community acquired pneumonia CAP has not been reported.

Case descriptionA 35-year-old male was admitted due to high fever, diffuse air-space consolidation in the right lung with ipsilateral pleural effusion and massive mediastinal and hilar lymphadenopathy without cervical lesions. On clinical suspicion of malignant lymphoma complicated with pneumonia, we performed a video-assisted thoracoscopic lymph node biopsy, and the diagnosis of KFD was established. Complete cure of the intrathoratic lesions was observed by administration of β-lactam antibiotics alone without steroid therapy.

Discussion and evaluationPrevious large case series have identified no pathogenic relationship between KFD and pneumonia. The hilar adenopathy could have caused airway compression leading to pneumonia.

ConclusionsKFD should be considered in the differential diagnosis of massive mediastinal and hilar lymphadenopathy, even when there are no superficial lesions. In addition, we need to bear in mind that unexpected disorders occasionally coexist with common diseases.

KeywordsKikuchi-Fujimoto disease Community acquired pneumonia Intrathoratic lymphadenopathy AbbreviationsKFDKikuchi-Fujimoto disease

CAPcommunity acquired pneumonia

CRPC-reactive protein

CTcomputed tomography

sIL-2Rsoluble interleukin-2 receptor

MLmalignant lymphoma

TAZ-PIPCtazobactam-piperacillin

COPcryptogenic organizing pneumonia

FDG PET-CT18-fluorodeoxyglucose positron emission-computed tomography

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Autor: Nobuhito Naito - Tsutomu Shinohara - Hisanori Machida - Hiroyuki Hino - Keishi Naruse - Fumitaka Ogushi

Fuente: https://link.springer.com/







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