Kikuchi-Fujimoto Disease Disseminated Tuberculosis as Trigger

Background: Kikuchi-Fujimoto disease (KFD) is an extremely rare, self-limiting inflammatory disease that often mimics malignancy, autoimmune diseases, or infections like tuberculosis. This report explores a complex case of KFD in a 36-year-old female, highlighting diagnostic challenges in a region with high tuberculosis prevalence. Methods: The patient presented with symptoms initially suggestive of disseminated tuberculosis, including fever, lymphadenopathy, and rash. Over the course of treatment, she developed atypical features such as distributive shock, disseminated intravascular coagulopathy, pulmonary congestion, acute kidney injury, and recurrent lymphadenopathy. Despite a history of anti-tubercular therapy and initial biopsy findings suggestive of tuberculosis, repeat lymph node biopsies confirmed Kikuchi-Fujimoto disease. Supportive care, including corticosteroids, antibiotics, blood transfusion and dialysis, led to clinical improvement and resolution of symptoms. Results: The case underscores the diagnostic complexity of KFD, particularly in tuberculosis-endemic areas. While the disease often presents with fever, fatigue, and cervical lymphadenopathy, its overlap with infectious and autoimmune conditions complicates diagnosis. Histopathology remains the cornerstone of diagnosis, distinguishing KFD from tuberculosis and malignancies. This report emphasizes the significance of taking into account KFD as a differential diagnosis in patients with persistent lymphadenopathy and systemic symptoms unresponsive to standard treatments. Early recognition and appropriate management are vital, as KFD typically resolves with supportive care, whereas misdiagnosis can lead to unnecessary therapies. Conclusion: Healthcare providers should maintain a high index of suspicion for KFD in similar clinical scenarios, particularly in regions with high tuberculosis prevalence. Enhanced awareness and thorough diagnostic workups, including biopsy and histological evaluation, are essential to improving outcomes.