Histiocytic necrotizing lymphadenitis (Kikuchi's disease) with aseptic meningitis

Histiocytic necrotizing lymphadenitis, or Kikuchi's disease (KD), is a self -limited clinicopathologic entity recognized increasingly worldwide. A 27-y ear-old man with cervical lymphadenopathy and fever who was diagnosed with KD developed mild headache with no nuchal rigidity. The cerebrospinal fluid (CSF) was sterile and contained 78 white blood cells/mm(3) with lymphocyte s predominating, accompanied by smaller numbers of monocytes and granulocyt es. This abnormality normalized spontaneously over 5 weeks. Eleven similar cases have been reported, all but one from Japan. The development of mening itis in KD was observed in four (9.8%) of 41 KD patients we have treated, s uggesting that the meningitis was related to KD and not merely coincidental . (C) 1999 Elsevier Science B.V: All rights reserved.