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The hypereosinophilic syndromes (HES) are a group of disorders marked by the sustained overproduction of eosinophils, resulting in multiple organ damage. We report a 55-year-old lady presented with sudden onset of left-sided limb weakness and hypereosinophilia. Cerebral computerised tomography scan showed multiple small infarctions in bilateral corona radiata and right thalamus. A transesophageal echocardiogram revealed endomyocardial damage with mural thrombus suggesting Loeffler endocarditis. The multiple cerebral infarctions were probably due to cardiac thromboembolism. Treatment with prednisolone led to significant clinical improvement. This case illustrates hypereosinophilia should be considered in patients with multiple cerebral infarctions.

The hypereosinophilic syndromes (HES) are a group of disorders marked by the sustained overproduction of eosinophils, resulting in multiple organ damage. We report a 55-year-old lady presented with sudden onset of left-sided limb weakness and hypereosinophilia. Cerebral computerised tomography scan showed multiple small infarctions in bilateral corona radiata and right thalamus. A transesophageal echocardiogram revealed endomyocardial damage with mural thrombus suggesting Loeffler endocarditis. The multiple cerebral infarctions were probably due to cardiac thromboembolism. Treatment with prednisolone led to significant clinical improvement. This case illustrates hypereosinophilia should be considered in patients with multiple cerebral infarctions.