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Acute cerebellar ataxia in pediatric legionellosis
Insights
Legionella pneumophila may cause acute cerebellar ataxia in children. This neurologic disorder presents with sudden hypotonia and walking difficulties, often preceded by pharyngitis.
Area of Science:
- Infectious Diseases
- Neurology
- Pediatrics
Background:
- Investigating the etiology of neurologic disorders in children is crucial for effective treatment.
- Legionella pneumophila is a known bacterial pathogen with diverse clinical manifestations.
Observation:
- Antibody titer increases against Legionella pneumophila were observed in children with acute cerebellar ataxia.
- Acute cerebellar ataxia presented as sudden hypotonia and inability to sit or walk.
- Symptoms included preceding pharyngitis, short-duration fever, and occasional gastrointestinal disturbances.
Findings:
- Three significant increases in antibody titers to Legionella pneumophila were detected in children with acute cerebellar ataxia.
- Laboratory findings included elevated ESR and leukocytosis with lymphocytosis.
- Cerebrospinal fluid and electromyographic findings were generally normal.
Implications:
- These findings suggest a potential etiological role for Legionella pneumophila in pediatric acute cerebellar ataxia.
- Early identification and targeted treatment could improve outcomes for affected children.
- Further research is warranted to confirm the link between Legionella pneumophila and this neurologic syndrome.
Abstract:
Acute-phase and convalescent-phase sera of 66 children, aged 3 months to 12 years, with neurologic disorders of unknown etiology were tested against Legionella pneumophila polyvalent and monovalent antigens (groups 1 to 4). Three significant antibody titer increases were obtained, all in children with acute cerebellar ataxia. This neurologic syndrome was characterized by sudden onset of muscle hypotonia and inability to sit or walk, with no other specific neurologic or systemic symptoms. Persisting pharyngitis always preceded ataxia. Fever of short duration was still present. Gastrointestinal disturbance occurred in two of the three children. Abnormal laboratory findings were, not always simultaneously, high ESR and leukocytosis with lymphocytosis. CSF levels and electromyographic findings were normal in two of the children. Two children received oral betamethasone. Recovery was complete within seven to ten days without antibiotic treatment. These studies indicate the possible etiologic role of L pneumophila in acute cerebellar ataxia.