Rapid Communication| Volume 163, ISSUE 2, P187-191, March 01, 1999

Download started.


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-year-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/mm3 with lymphocytes predominating, accompanied by smaller numbers of monocytes and granulocytes. This abnormality normalized spontaneously over 5 weeks. Eleven similar cases have been reported, all but one from Japan. The development of meningitis in KD was observed in four (9.8%) of 41 KD patients we have treated, suggesting that the meningitis was related to KD and not merely coincidental.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Debley J.S.
        • Rozansky D.J.
        • Miller M.L.
        • Katz B.Z.
        • Greene M.E.
        Histiocytic necrotizing lymphadenitis with autoimmune phenomena and meningitis in a 14-year-old girl.
        Pediatrics. 1996; 98: 130-133
        • Dorfman R.F.
        • Berry G.J.
        Kikuchi’s histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis.
        Semin Diagn Pathol. 1988; 5: 329-345
        • Erzurum S.
        • Kalavsky S.M.
        Acute cerebellar ataxia and hearing loss as initial symptoms of infectious mononucleosis.
        Arch Neurol. 1983; 40: 760-762
        • Hollingsworth H.C.
        • Peiper S.C.
        • Weiss L.M.
        • Raffeld M.
        • Jaffe E.S.
        An investigation of the viral pathogenesis of Kikuchi–Fujimoto disease. Lack of evidence for Epstein–Barr virus or human herpesvirus type 6 as the causative agent.
        Arch Pathol Lab Med. 1994; 118: 134-140
        • Kikuchi M.
        Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes.
        Acta Hematol Jpn. 1972; 35 (in Japanese): 379-380
        • Kuo T.
        Kikuchi’s disease (histiocytic necrotizing lymphadenitis). A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy.
        Am J Surg Pathol. 1995; 19: 798-809
        • Murata S.
        • Nakamura M.
        • Ogawa M.
        • Sawada T.
        A case of acute cerebellar ataxia associated with subacute necrotizing lymphadenitis.
        Neurol Med (Tokyo). 1989; 31 (in Japanese): 70-74
        • Nagata A.
        • Shoji H.
        • Kaji M.
        A case of subacute necrotizing lymphadenitis with acute cerebellar ataxia.
        Rinsho Shinkeigaku. 1986; 26 (in Japanese with English abstract): 354-357
        • Nishiyama K.
        • Sakai K.
        • Takeda K.
        • Terao Y.
        • Sakuta M.
        Subacute necrotizing lymphadenitis associated with encephalitis, successfully treated by vidarabine. A case report.
        Neurol Med (Tokyo). 1993; 39 (in Japanese): 428-430
        • Pileri S.
        • Kikuchi M.
        • Helbron D.
        • Lennert K.
        Histiocytic necrotizing lymphadenitis without granulocytic infiltration.
        Virchows Arch (Pathol Anat). 1982; 395: 257-271
        • Sato T.
        • Narita S.
        • Kaimori M.
        • Maeda S.
        • Matsunaga M.
        A case of necrotizing lymphadenitis with primary position upbeat nystagmus.
        Neurol Med (Tokyo). 1988; 29 (in Japanese): 197-199
        • Turner R.R.
        • Martin J.
        • Dorfman R.F.
        Necrotizing lymphadenitis. A study of 30 cases.
        Am J Surg Pathol. 1983; 7: 115-123
        • Unger P.D.
        • Rappaport K.M.
        • Strauchen J.A.
        Necrotizing lymphadenitis (Kikuchi’s disease): report of four cases of an unusual pseudolymphomatous lesion and immunologic marker studies.
        Arch Pathol Lab Med. 1987; 111: 1031-1034