Unravelling Kikuchi-Fujimoto Disease: A Unique Presentation of Recurrent Aseptic Meningitis in a District Hospital Setting

Kikuchi-Fujimoto disease (KFD) is a rare, self-limiting, and ultimately benign condition characterised by localised lymphadenopathy. The association of KFD with aseptic meningitis is even more uncommon. We report a case of KFD accompanied by aseptic meningitis in a 31-year-old male who initially presented with lethargy, night sweats, axillary lymphadenopathy, and oral ulcers. Initial differential diagnoses included Lyme disease and lymphoma, which were subsequently ruled out. The patient presented again 10 days later with a severe headache. Neurological examination revealed negative Kernig and Brudzinski signs and normal motor power, tone, and reflexes. Lumbar puncture (LP) indicated normal glucose and white cell count. A lymph node biopsy confirmed the diagnosis of Kikuchi's disease with aseptic meningitis. This case underscores the importance of considering KFD in patients presenting with lymphoma-like symptoms.