Kikuchi-Fujimoto disease is a rare histiocytic necrotizing lymphadenitis that affects typically young women causing fever and painful laterocervical lymphadenopathy. The etiology is unknown, but several viral infections and autoimmune diseases have been related with the disease. Bacterial infections are less frequent. Diagnosis needs for excisional lymph node biopsy that shows paracortical areas of coagulative necrosis with abundant debris, distortion of the nodal architecture, and a large amount of histiocytes at the margins of the necrotic areas. There is no specific treatment for the disease. We present the case of a young woman with Kikuchi-Fujimoto disease associated with lower respiratory tract infection by Streptococcus pneumoniae and review the literature.