ABSTRACT
Idiopathic hypereosinophilic syndrome (IHES) is a rare systemic disorder that's characterized by peripheral eosinophilia and eosinophilic infiltration of multiple organs, including the heart, lungs, skin, liver, gastrointestinal tract and nervous system. IHES is associated with a broad range of clinical findings, depending on the involved organ and the severity of the infiltration. The diverse modes of clinical presentation occasionally lead to a false clinical diagnosis. There are no specific tests for diagnosing IHES, and the therapies remain controversial. In this report, we describe a 34-year-old man with IHES that was associated with multiple brain infarctions in both cerebral and cerebellar hemispheres. Five months earlier, the patient presented with erythematous scaly hyperkeratotic skin lesions on both legs. He was treated with anticoagulation therapy, aspirin and topical corticosteroid for about 1 month. All his symptoms and signs dramatically improved, except for the persistent peripheral eosinophilia. On follow-up after 8 months, the patient remained well without relapse or new lesions.