Seizure and cardiac arrest in a case of chronic rhinosinusitis, Churg-Strauss syndrome on autopsy.

A young male in his 20s, previously diagnosed with a case of chronic rhinosinusitis with nasal polyps, was started on a course of oral steroids. He suddenly developed an episode of seizures and failed to regain consciousness. Within an hour, he suffered cardiac arrest and subsequently succumbed to the illness. An autopsy revealed bilateral consolidation of the lower lobes of the lung, left ventricular hypertrophy of the heart and cerebral oedema. Histopathological examination showed eosinophilic infiltrates in the myocardium, submucosa of oesophagus and brain. Eosinophilic vasculitis of medium-sized vessels was seen. Following this, a diagnosis of Churg-Strauss syndrome was made. This case shows that Churg-Strauss syndrome, a rare disease in itself, may infrequently present with sudden cardiac death without having any signs or symptoms of asthma previously. It highlights the need to remain vigilant with regard to secondary causes in cases of long-standing chronic rhinosinusitis.