 Adult subjects unable to provide consent during an acute episode of SCLS may be included in this study. Specimens from an acute phase of an SCLS episode are time-sensitive, and may yield critical information regarding potential causative factors or acute cellular abnormalities that correlate with clinical features of SCLS. Due to the life-threatening nature of SCLS episodes, a subject may suddenly require intensive care management at the subject s local institution, rendering the subject unable to provide hisher own consent. While incapacitated, a MedicalLegal Guardian or Legally Authorized Representative LAR may provide Off Site consent for the collection of time-sensitive, critical specimens. An NIAID staff member who is able to obtain consent for this protocol may obtain consent from the MedicalLegal Guardian or LAR. Although there may be no direct benefit to the subject, research blood specimens may be obtained with minimal risk, and tissue samples will only be obtained as described in section 4.1.6. Once the acute phase resolves, and the subject is able to give hisher own consent, a previously incapacitated adult may be re-consented. 