Intracerebral hemorrhage in a patient with Churg-Strauss syndrome.

Sir, A 45-year-old man was admitted with history of painful, sequential multiple peripheral nerve involvement for four months. On questioning he revealed history of allergic rhinitis with recurrent nasal polyps, bronchial asthma for two years, weight loss, joint pains with swelling and Raynaud’s phenomenon of four months duration. Examination revealed skin rash and features of mononeuritis multiplex. Investigations showed eosinophilia (absolute eosinophil count-14600/ microliter), raised ESR and leucocytosis. The HIV serology, HbsAg, anti-HBc, antinuclear antibody and antineutrophilic cytoplasmic antibody were negative. Serum creatinine was normal and urine examination was unremarkable. Skin biopsy showed evidence of small vessel vasculitis with eosinophilic infiltrate [Figures 1a and 1b]. Nerve biopsy showed evidence Survival in rhinocerebral mucormycosis: Is iron the key?