Acute cerebellitis following hemolytic streptococcal infection.

BACKGROUND: Acute cerebellitis is a rare inflammatory syndrome in children, with either infectious or autoimmune etiologies. PATIENT: We describe a 7-year-old girl with a presentation of cerebellitis following group A streptococcal infection. RESULTS: Magnetic resonance imaging showed diffuse symmetrical swelling and edema of the cerebellum resulting in compression of the fourth ventricle and hydrocephalus. Autoantibodies against glutamate receptor δ2 were detected in the cerebrospinal fluid, suggesting that the cerebellum might be injured by postinfectious immunologic reaction. The most common causes of cerebellitis are acute viral infection, postinfection, and following vaccination. No examples of acute cerebellitis following group A streptococcal infection have been documented. CONCLUSION: Our report demonstrates that group A streptococcal can lead to acute cerebellitis.

Elevated numbers of cells producing interleukin-5 and interleukin-10 in a boy with Kimura disease.

Kimura disease is a rare disorder of unknown etiology, characterized by the presence of benign subcutaneous granuloma, marked peripheral blood eosinophilia and elevation of the immunglobulin E (IgE) serum level. Here, we present a case of a 12-year-old boy with Kimura disease who had a history of repeated severe influenza virus A infection. Along with the characteristic histological findings of granuloma, including eosinophil infiltration, enzyme-linked immunospot assay showed elevated numbers of IL-5- and IL-10-producing cells in the peripheral blood. Immunohistochemical evaluation, however, did not detect IL-5 in the tissue. Possible cytokine dysregulation in Kimura disease was suggested, but the pathogenesis remains unclear.