A case of Cryptococcus neoformans meningitis in a patient with abnormal levels of isolated immunological markers

Cryptococcal meningitis is considered rare in immunocompetent patients and is mainly a disease of immunocompromised patients. We report a case of cryptococcal meningitis, due to Cryptococcus neoformans, in an apparently healthy individual with abnormal levels of isolated immunological markers. Regardless of the patient's immune status, the result of the disease can be serious unless the disease is diagnosed early.

Epstein-Barr virus encephalitis with substantia nigra involvement

Infectious mononucleosis due to Epstein-Barr virus (EBV) is a usually benign systemic viral illness common in children. Many studies described nervous system manifestations of infectious mononucleosis with a wide spectrum of neurologic deficits. Neurologic complications of EBV are seen in both acute and reactivate infection. Herein, we describe a patient diagnosed by acute EBV encephalitis with substantia nigra involvement and excellent clinical recovery.

X-linked adrenoleukodystrophy in a 6-year-old boy initially presenting with psychiatric symptoms

X-linked adrenoleukodystrophy (ALD) leads to demyelination of the nervous system, adrenal insufficiency and accumulation of long-chain fatty acids. Most young patients with X-linked ALD develop seizures and progressive neurologic deficits, and die within the first two decades of life. We present the case of a 6-year-old with childhood-onset ALD, first presenting with psychiatric symptoms and progressive gait difficulties, slurred speech and cognitive impairment. Genetic testing was performed and a p.R401Q (c.1202G>A) mutation detected in the ABCD1 gene. ALD should be considered in the differential diagnosis of patients presenting with behavior changes and white matter disease in neuroimaging.

Ring chromosome 14 syndrome presenting with intractable epilepsy: a case report

Ring chromosome 14 syndrome is a rare genetic disorder. Typically, children with this syndrome have distinct facial features, development delay, microcephaly, seizures, ocular abnormalities, and recurrent respiratory infections. Epilepsy associated with ring chromosome 14 generally shows intractable seizures. We describe a six-month-old girl with ring chromosome 14 syndrome who presented with early-onset and drug-resistant seizures.

Posterior reversible encephalopathy syndrome due to pulse methylprednisolone therapy in a child

Posterior reversible leukoencephalopathy syndrome (PRES) is a recently described disorder with typical radiological findings of bilateral grey and white matter abnormalities in the posterior regions of the cerebral hemispheres. It has been described in children in association with some medications, renal disease, autoimmune disease, transplantation, and sepsis. In this report, we discuss an eight-year-old boy with PRES during pulse methylprednisolone therapy. In conclusion, PRES is a neurological complication of pulse methylprednisolone therapy, which responds favorably to prompt therapy withdrawal and blood pressure control.

Acute cerebellar ataxia associated with enteric fever in a child: a case report

Enteric fever is a common infectious disease of the tropical world. Characteristic presenting features include fever, relative bradycardia, diarrhea or constipation, and abdominal pain. Central nervous system involvement is not rare and has a wide spectrum of presentation in enteric fever. Complications such as meningism, delirium, coma, and convulsions have been reported often. However, isolated acute cerebellar ataxia associated with enteric fever is rare. Here, we report a seven-year-old boy with enteric fever who presented with acute cerebellar ataxia. Following treatment with appropriate antibiotics, the patient showed complete recovery over the next four weeks.