A 27-year old woman presented with fever, weight loss, arthralgia, macular skin rash and bilateral axillary lymphadenopathy. The histology of an excised lymph node showed evidence suggestive of Kikuchi disease. Subsequent laboratory tests showed evidence of Systemic Lupus Erythematosus, underscoring the importance of considering other diagnoses in a nodal histological diagnosis of Kikuchi disease, a benign condition of unknown aetiology.
A study was done on 638 infants with BCG related lymphadenitis seen between August 1990 and December 1993. Most infants (86.5%) had developed symptoms by six months after vaccination and the nodes became suppurative in 317. Surgical procedures were carried out in 82 cases and the rest were managed conservatively. The mean duration to resolution was 6.6 months (range 1 to 29 months). This outbreak was related to a change from the Japan to the Pasteur strain of BCG. The incidence remained high ( > 15 per 1000 live births) despite a dose reduction from 0.1 ml to 0.05 ml, but declined when the Japan strain was reintroduced in April 1992.
Study site: Chest Clinic, Hospital Pulau Pinang, Malaysia