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  • 13 Once the DRESS symptoms had resolved, a new treatment regimen similar to that used for multi-drug resistant TB was initiated slowly.13 15 The most common offending agent was rifampicin, and when restarting antituberculous medication levofloxacin was the best tolerated.13�C15 In the few

    studies reporting antituberculous medication leading to DRESS, HHV-7 had not been tested.13�C15 To our knowledge, our case is the first to detect HHV-7 DNA in a definite DRESS case after anti-TB drugs administration. Learning points Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse reaction with a high mortality rate. DRESS syndrome can be associated with other herpes viruses including human herpes virus 7. DRESS syndrome can occur due to antituberculous medication, and alternatives antituberculous regimen will need to be started. If medication causing DRESS is stopped promptly, there may be no role for steroids. Acknowledgments The authors express their sincere thanks to Dr Tanzina Haque (Consultant virology, Senior lecturer Royal Free Hospital and UCL Medical School) for her advice on investigating the case and revising the manuscript. Footnotes Contributors: All authors have made an individual

    contribution to the writing and have seen and approved the final version of the manuscript. Competing interests: None. Patient consent: Obtained. Provenance and peer review: Not commissioned; externally peer reviewed.""Primary central nervous system lymphoma (PCNSL) is a rare tumour of childhood with 15�C20 cases reported yearly in North America.1 Given the rarity of this disease in children, little is known regarding clinical features, treatment strategies and prognosis. Clinical presentation of PCNSL may include severe headaches, vomiting, papilloedema, facial nerve palsy, diplopia, dysarthria, ataxia, bulbar palsy, quadriparesis and obtundation.2�C6 Rarer signs and symptoms including seizures, acute blindness, proptosis,

    lower and upper-limb muscle weakness, nystagmus, paraesthesias, personality change, lethargy and somnolence have been reported.3 5 7�C10 Intracranial haemorrhage either at presentation or subsequent to therapy has not been reported. We report a case of a 13-year-old boy diagnosed with a Vemurafenib in vitro cerebellar PCNSL who underwent successful chemotherapy treatment presented with a traumatic basal ganglia haemorrhage following a concussion more than 1.5?years postdiagnosis associated with a new mild hemiparesis. To the best of our knowledge this is the first case of a traumatic basal ganglia haemorrhage in a child associated with PCNSL. Case presentation A 13-year-old boy presented to our hospital with progressive headaches, imbalance and acute episode of vomiting and fever. Neurological examination revealed gaze-evoked nystagmus, bilateral dysmetria and a wide-based ataxic gait.

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