eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-03-18 9 6 321 324 10.12691/ajmcr-9-6-4 AJMCR2021964 article Ahmed Hashim ahmed.m.hashim89@gmail.com 1 Mohamedanwar Ghandour 2 Hammam Shereef 2 Ahmed H Abdulrahim 3 Rabia Bangash 3 Faisal Musa 4 Fadi Abu Yasin 5 Department of Internal Medicine, Beaumont Health- Dearborn, MI, USA Division of Nephrology, Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, USA Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, USA Division of Oncology, Department of Internal Medicine, Beaumont Health- Dearborn, MI, USA Division of Infectious Diseases, Department of Internal Medicine, Beaumont Health- Dearborn, MI, USA We report a case of Kikuchi-Fujimoto disease (KFD) in an 18-year-old African American female who presents with a high-grade fever, sweating, and painful right-sided cervical lymphadenopathy. Lab analysis showed leukopenia, thrombocytopenia, and an elevated C-reactive protein. The remaining infectious and autoimmune work-up was negative. Given her clinical presentation, an infectious etiology was suspected, and broad-spectrum antibiotics were empirically started. Bicytopenia in the setting of lymphadenopathy raised the suspicion for lymphoma with bone marrow infiltration. An excisional biopsy was performed, and a histological exam of the lymph nodes showed necrotizing histiocytic lymphadenitis consistent with KFD. She was discharged on Naproxen and Tylenol with a referral to Rheumatology. This case highlights the rarity of bicytopenia in KFD and the importance of early and prompt diagnosis in order to avoid unnecessary testing and inappropriate treatment. http://pubs.sciepub.com/ajmcr/9/6/4/ajmcr-9-6-4.pdf Kikuchi-Fujimoto Disease lymphadenopathy