1Junior Resident, Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, India
Email: samreenshaikh120998@gmail.com
2Professor, Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, India
Email: sureshkannatmc@gmail.com
3Assistant Professor, Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, India
Email: rarvind2007@gmail.com
4Assistant Professor, Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, India
Email: prakashkmc12@gmail.com
5Senior Resident, Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, India
Email: akitagopinathgopal@gmail.com
6Junior Resident, Department of General Medicine, Sree Balaji Medical College and Hospital, Chennai, India
Email: anikethreddygaddam@gmail.com
Received: 18th Sep, 2025; Revised: 26th Oct, 2025; Accepted: 26th Nov, 2025; Available Online: 1st December, 2025
Background: Kikuchi-Fujimoto Disease (KFD) is a rare, benign, self limiting necrotizing lymphadenopathy, frequently mistaken to be infectious, autoimmune or neoplastic disease. HLH is life-threatening hyperinflammatory syndrome that is capable of sometimes complicating KFD.
Case Presentation: On this occasion, we present a case of an 18-year-old female client who has a history of fever, cytopenias, and neurological symptoms. Primary tests showed the presence of lymphadenitis in keeping with KFD, positive auto-immune antibodies and an increase in inflammatory parameters. She acquired the symptoms of HLH with hyperferritinemia (>50,000 ng/mL), intractable cytopenias, and dysfunction in the organs despite therapy. She needed to be under high-dose corticosteroid therapy, etoposide, intravenous immunoglobulin, and immunosuppressants. Primary HLH was eliminated by genetic testing. The patient improved slowly and was afebrile on follow up, but she went on to have hydroxychloroquine-related retinal toxicity.
Conclusion: The present case demonstrates the possibility of diagnostic difficulty of prolonged fever in young adults and reminds us of the importance of the early detection of HLH in the context of KFD. Timely immunosuppressive treatment and multidisciplinary approach is important to achieve positive results.
Keywords: Kikuchi-Fujimoto Disease, Hemophagocytic Lymphohistiocytosis, Fever of Unknown Origin, Autoimmunity, Case Report.
How to cite this article: Anwar SS, Subramaniam SK, Arvindraj R, Gnanaprakash C, Gopinath A, Gaddam AR. Fever with Twists: A Rare Case of Kikuchi-Fujimoto Disease Complicated by Hemophagocytic Lymphohistiocytosis. Int J Drug Deliv Technol. 2026;16(1): 672-675; DOI: 10.25258/ijddt.16.1.69
Source of support: None
Conflict of interest: None