Sweet's syndrome associated with encephalitis

The involvement of the central nervous system (CNS) in Sweet's syndrome (ac ute febrile neutrophilic dermatosis) is rare. We report a 47-year-old woman who presented with acute encephalitis and was subsequently diagnosed as ha ving Sweet's syndrome. She developed altered consciousness following fever and erythematous skin plaques in the extremities. Cerebrospinal fluid (CSF) examination disclosed neutrophilic pleocytosis without decreased glucose l evel. Brain magnetic resonance imaging (MRI) showed abnormal signal intensi ty lesions in the basal ganglia and the hippocampus. Skin biopsy revealed a dense dermal infiltration of neutrophils. which is compatible with Sweet's syndrome. Treatment with acyclovir and antibiotics failed, but the subsequ ent corticosteroid therapy was effective. Awareness of neurological complic ation in Sweet's syndrome may avoid unnecessary empiric therapy for meningo encephalitis and will lead to a successful treatment with corticosteroids. (C) 2001 Elsevier Science B.V. All rights reserved.