PEDIATRICS Vol. 72 No. 6 December 1983, pp. 847-849
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Acute Cerebellar Ataxia in Pediatric Legionellosis

Giovanni Nigro MD1, Maddalena Castellani Pastoris DBiol1, Mirella Mazzotti Fantasia MD1, and Mario Midulla MD1

1 From the IV Clinica Pediatrica Università Roma, Centro CNR Virus Respiratori and Laboratorio di batteriologia e Micologia, Istituto Superiore di Sanità, Rome

Acute-phase and convalescent-phase sera of 66 children, aged 3 months to 12 years, with neurologic disorders of unknown etiology were tested against Legioneila pneumophila polyvalent and monovalent antigens (groups 1 to 4). Three significant antibody titer increases were obtained, all in childlren 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.

Key Words: legionellosis • acute cerebellar ataxia

Submitted on October 26, 1982
Accepted on February 4, 1983