Chronic Fever with Recurent Cervical Cystic Lymphadenitis as Long COVID-19 Alertness to Kikuchi-Fujimoto Disease and Autoimmune Disease in the Future

Abstract

Long COVID-19 are becoming more common and may continue to rise in the future. It is important to be aware of the emergence of hyperimmune responses and autoimmune diseases following COVID-19. Infection, including viral infections, has been linked to the onset of autoimmune diseases. A 31-year-old woman who works as front officer of a COVID-19 clinic experienced signs and symptoms of long COVID-19, manifested as sterile chronic fever and recurrent cervical cystic lymphadenitis and several other symptoms that suggest a hyperimmune response. Lymph node histology revealed cystic appearance and histiocyte dominance with starry sky formation, that made the suspicion of Kikuchi-Fujimoto disease. Treatment with steroids temporarily improves symptoms, and hydroxychloroquine stops all symptoms and signs. Follow-up of this case is necessary due to its association with autoimmune disease in the future.