Mycobacterium szulgai lymphadenitis mimicking Kikuchi's disease in Thailand

Abstract

Mycobacterium szulgai is rarely found to be a cause of reported infection. Two thirds of cases were reported as pulmonary presentations, while the rest were infections of soft tissues or bone. In Thailand, few pulmonary infections due to M. szulgai have been reported. This is the first case of M. szulgai lymphadenitis confirmed by tissue culture. The patient presented with prolonged fever and tender enlarged cervical nodes. Histological findings showed large histiocytes with necrotic background compatible with Kikuchi's disease. However, the culture proved the case to be one of M. szulgai infection. That means this mycobacterium should be included in the differential diagnosis of fever with lymphadenitis.