A 2-year-old boy had a fatal disseminated BCG infection. Immunologic assessment showed a normal humoral response and normal numbers of E rosettes, normal thymus weight and histological features, but an abnormal response of lymphocytes in vitro and negative skin tests. Histological examination showed the presence of Gram-negative acid-fast bacilli within the macrophages. The possible mechanisms of immunodeficiency in this patient are discussed.
The Kleine-Levin syndrome is characterized by recurring attacks of morbid sleep, excessive eating, and mental disturbances lasting for a set period of time. Neither an organic factor nor a psychological disorder has been found to be causative in this syndrome.
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