Scrub Typhus with Guillain-Barrè Syndrome: Section An Atypical Sequela due to Delayed Diagnosis
Correspondence Address :
Dr. Mukesh Bairwa,
Assistant Professor, Department of Internal Medicine, All India Institute of Medical
Science, Rishikesh, Dehradun, Uttarakhand, India.
E-mail: drmukeshbairwa1982@gmail.com
Scrub typhus is a zoonotic infection which is endemic to the tropical regions of South-East Asia including the sub-Himalayan belt of North India. Clinical manifestations of scrub typhus range from self-limiting acute febrile illness to sometimes fatal multi-organ involvement. However, it does not usually involve the central nervous system, if affected meningoencephalitis is the most common presentation. Hereby the authors report a 60-year-old patient of scrub encephalitis who developed acute onset ascending, symmetric flaccid quadriparesis with sensory involvement. Electrophysiological studies and demonstration of antiganglioside antibodies confirmed the diagnosis of AMSAN variant of Guillain-Barré syndrome. The patient was treated successfully with five days of intravenous immunoglobulins. She became ambulatory with complete recovery four weeks after discharge. Guillain-Barré syndrome is a treatable entity and should be evaluated in all cases of scrub typhus having a similar presentation. It can lead to a diagnostic challenge that can often be missed as it is a rare presentation of scrub infection. Therefore, prompt diagnosis and treatment is necessary for better outcomes.
Encephalitis, Quadriparesis, Rickettsia
10.7860/JCDR/2021/49948.15515
Date of Submission: Apr 16, 2021
Date of Peer Review: Jul 29, 2021
Date of Acceptance: Sep 16, 2021
Date of Publishing: Oct 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Apr 17, 2021
• Manual Googling: Sep 15, 2021
• iThenticate Software: Sep 30, 2021 (14%)
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