{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:39:00Z","timestamp":1792100340631,"version":"4.4.0"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Jinling Hospital","award":["2024LLYYXH011"],"award-info":[{"award-number":["2024LLYYXH011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fever accompanied by disseminated lymphadenopathy presents a significant diagnostic challenge. Our prior clinical observations indicated a high detection rate of Nocardia farcinica (N. farcinica) deoxyribonucleic acid (DNA) in patients with this presentation. Kikuchi\u2013Fujimoto disease (KFD) is a common cause in young adults with fever and lymphadenopathy, yet its etiological drivers remain largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This dual-center study aimed to investigate the prevalence of N. farcinica infection in a pathologically confirmed KFD cohort, to analyze its correlation with clinical phenotypes, particularly systemic involvement, in comparison to Castleman disease (CD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Formalin-fixed, paraffin-embedded tissue specimens from 35 and 18 people with KFD and CD, respectively, were tested by N. farcinica-specific quantitative real-time polymerase chain reaction (qPCR). Clinical and imaging data were reviewed for comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nocardia farcinica DNA was significantly more prevalent in KFD (51.4%) than in CD (5.6%) (P &amp;lt; .001). Within KFD, positive people were older, had a shorter onset-to-presentation interval, and exhibited more pronounced leukopenia (all P &amp;lt; .05). A history of recent trauma (11.1% vs 0%) and immunosuppression (5.6% vs 0%) was exclusively documented in the N. farcinica-positive group, albeit in small number. Furthermore, N. farcinica-positive patients showed a higher, though not statistically significant, prevalence of bilateral lymph node involvement (72.2% vs 52.9%, P = .34) and a trend toward involvement of more nodal regions compared to negative counterparts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated a potential association between N. farcinica and KFD, suggesting a clinical subtype characterized by older age, shorter onset-to-presentation interval, and significant leukopenia. These findings offer novel etiological insights and suggest potential targeted therapeutic approaches, warranting validation through larger prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf716","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T12:56:18Z","timestamp":1766062578000},"page":"35-40","source":"Crossref","is-referenced-by-count":1,"title":["<i>Nocardia farcinica<\/i>\n                    as a Potential Pathogen Associated With a Clinical Subtype of Kikuchi\u2013Fujimoto Disease"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5995-8421","authenticated-orcid":false,"given":"Le","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongtong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muzi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiming","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Integrative Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-6646","authenticated-orcid":false,"given":"Yi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pathology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"2026072309022197400_ciaf716-B1","first-page":"120","article-title":"Kikuchi-Fujimoto disease: a clinicopathologic update","volume":"108","author":"Pepe","year":"2016","journal-title":"Pathologica"},{"key":"2026072309022197400_ciaf716-B2","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1186\/s12887-025-05831-1","article-title":"Clinical characteristics and risk factors for recurrence of Kikuchi-Fujimoto disease in children: a case-control study","volume":"25","author":"Liu","year":"2025","journal-title":"BMC Pediatr"},{"key":"2026072309022197400_ciaf716-B3","first-page":"362","article-title":"Detection of human herpesvirus DNA in Kikuchi-Fujimoto disease and reactive lymphoid hyperplasia","volume":"1","author":"Hudnall","year":"2008","journal-title":"Int J Clin Exp Pathol"},{"key":"2026072309022197400_ciaf716-B4","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/S0046-8177(98)90419-1","article-title":"Kaposi's sarcoma-associated herpesvirus in Kikuchi's disease","volume":"29","author":"Huh","year":"1998","journal-title":"Hum Pathol"},{"key":"2026072309022197400_ciaf716-B5","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.cmi.2025.05.004","article-title":"Insidious infections of Nocardia farcinica in immunocompetent individuals with fever of unknown origin and disseminated lymphadenopathy","volume":"31","author":"Lu","year":"2025","journal-title":"Clin Microbiol Infect"},{"key":"2026072309022197400_ciaf716-B6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.3389\/fcimb.2017.00194","article-title":"Nocardia cyriacigeorgica from bovine mastitis induced In vitro apoptosis of bovine mammary epithelial cells via activation of mitochondrial-caspase pathway","volume":"7","author":"Chen","year":"2017","journal-title":"Front Cell Infect Microbiol"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf716\/66038266\/ciaf716.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/83\/1\/35\/66038266\/ciaf716.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/83\/1\/35\/66038266\/ciaf716.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:02:27Z","timestamp":1784811747000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/83\/1\/35\/8384366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12,19]]},"published-print":{"date-parts":[[2026,7,23]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf716","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7,15]]},"published":{"date-parts":[[2025,12,19]]}}}