Haemophagocytic syndrome and histiocytic necrotising lymphadenitis (Kikuchi's disease)

A young boy presented with a rash, fever, and cervical lymphadenopathy, ori ginally thought to be caused by tuberculosis. A lymph node biopsy showed th e features of Kikuchi's disease, with necrosis and histiocytic infiltration without neutrophils. No evidence of tuberculosis was found on staining, cu lture, or the polymerase chain reaction. Bone marrow biopsy revealed promin ent haemophagocytosis, and a diagnosis of haemophagocytic syndrome was reac hed. The aetiology of haemophagocytic syndrome, and its association with Ki kuchi's lymphadenitis, is discussed.