Neuro-Behçet's/neuro-Sweet's disease presents simultaneously with severe tonsillitis, and features mimicking bacterial menigitis with skin lesions

Abstract

The patient was hospitalized due to rapidly undulant fever and sore throat. Empirical antibiotic therapy was started, however, headache also occurred. Lumbar puncture disclosed polynuclear leukocyte-predominant pleocytosis indicating that the patient suffered from bacterial meningitis. The antibiotics therapy was increased, however, consciousness became impaired and erythema multiforme-like skin lesions appeared. T2-weighted brain magnetic resonance imaging showed high signal intensity in the brainstem. HLA testing revealed B54 and Cw1. The patient presented futures of Behçet's disease at the same time as those of Sweet's syndrome and it was difficult to distinguish between the two diseases. Administration of prednisolone showed remarkable effect. © 2006 The Japanese Society of Internal Medicine.