Background: Kikuchi, histiocytic necrotizing lymphadenitis, is a rare inflammatory disease that typically affects the cervical lymph nodes. Kikuchi is a benign disorder which most commonly resolved spontaneously over several weeks to months. This disease may mimic lymphoma and is definitely diagnosed by lymph node pathology.

Case Report: The case was a 26-year-old woman with fever, chill, right-sided neck swelling accompanied by lower extremity pain, nausea, loss of appetite, and headache since 10 days ago. On examination, the spleen was palpable about 5 cm below the costal margin. Despite the continuation of antibiotic therapy and persistent fever, cervical lymphadenopathy, splenomegaly, leukopenia and elevated ESR, biopsy of lymph nodes was performed to rule out lymphoma and to establish Kikuchi’s disease. After 20 days the patient was discharged from the hospital.

Conclusion: In every patient, especially young woman, with prolonged fever and enlarged lymph node, Kikuchi disease should be considered in the differential diagnosis and consequently the lymph node biopsy is recommended.