scholarly journals Methicillin-resistant Staphylococcus aureus Pyomyositis inducing Guillain-Barré Syndrome - A rare and unexpected clinical presentation

2021 ◽  
Vol 5 (4) ◽  
pp. 315-319
Author(s):  
Manoj Sharma ◽  
Gurpreet Kaur-Dhillon ◽  
Shibu Sasidharan ◽  
Harpreet Singh-Dhillon ◽  
Babitha Shibu
Keyword(s):  
Clinical Presentation ◽  
North India ◽  
Guillain Barre Syndrome ◽  
Methicillin Resistant ◽  
Guillain Barré Syndrome ◽  
Muscle Infection ◽  
Guillain Barré ◽  
Staphylococcal Aureus ◽  
High Index Of Suspicion ◽  
Tropical Pyomyositis

Tropical pyomyositis is characterized by deep suppurative skeletal muscle infection most commonly by Staphylococcal Aureus (S. aureus) with increasing incidence of infection by community acquired methicillin resistant S. aureus(CA-MRSA). The initial clinical presentation is generally non-specific and requires a high index of suspicion. We report the clinical course of a child from subtropical area of North India who developed multiple deep pyogenous collections, complicated with CA-MRSA septicaemia and followed by unusual complications consistent with Guillain-Barré Syndrome.

scholarly journals Colistin neurotoxicity mimicking Guillain-Barré syndrome in a patient with cystic fibrosis: case report and review

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Celeste Camargo ◽  
Tathagat Narula ◽  
Daniel A Jackson ◽  
Teresa Padro ◽  
W David Freeman
Keyword(s):  
Cystic Fibrosis ◽  
Drug Toxicity ◽  
Clinical Presentation ◽  
Guillain Barre Syndrome ◽  
Drug Induced ◽  
Common Presentation ◽  
Intravenous Treatment ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ABSTRACT Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy, which is characterized by areflexia and ascending paresthesia which can progress to a respiratory failure. Certain conditions, such as vasculitis and heavy metal and drug toxicity, may have misleadingly similar clinical presentation to GBS. We describe a case of a patient with cystic fibrosis and intravenous colistin-induced neurotoxicity mimicking GBS. The patient had used inhaled colistin on five occasions with no adverse effects, however, developed symptoms on the second day of intravenous treatment. Overlapping findings between immune-mediated polyneuropathy and drug-induced neurotoxicity include limb paresthesia and decreased reflexes. Perioral tingling, however, is a common presentation of colistin-induced neurotoxicity, and therefore, is an important differentiating factor. Early diagnosis prevents further neurologic decline, extensive unnecessary workup and potentially harmful incorrect management.

scholarly journals Acute inflammatory polyradiculoneuropathy of atypical presentation.

2021 ◽  
Author(s):  
Yasmim Nadime José Frigo ◽  
Hendrick Henrique Fernandes Gramasco ◽  
Ana Flavia Andrade ◽  
Guilherme Drumond Jardini Anastácio ◽  
Stella de Angelis Trivellato ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Peripheral Facial Paralysis ◽  
Early Improvement ◽  
Guillain Barré Syndrome ◽  
Symptom Variability ◽  
Guillain Barré ◽  
Trigeminal Nerves ◽  
Peripheral Sensory

Introduction: Guillain-Barré syndrome is an acute / subacute inflammatory polyradiculoneuropathy that classically results in flaccid areflex palsy. However, there are other possibilities of clinical presentation that must be remembered so that an adequate diagnosis and treatment is carried out. Case report: Female patient, 23 years old, without comorbidities, with complaint of paresthesia in extremities and right peripheral facial paralysis, having diagnosis until then of Bell’s Palsy. She denied previous or current infectious complaints. The neurological examination revealed facial diparesis, proximal weakness of the lower limbs that made walking difficult, tactile and painful hypoesthesia in the feet, with reflexes 1+/4+ in the lower limbs and 3+/4+ in the upper limbs. An investigation was started with CSF collection that showed albuminocytological dissociation (proteins 440 mg/dl and leukocytes 01 mm3). Neuroimaging exams showed contrast impregnation in facial and trigeminal nerves. A diagnosis of acute inflammatory polyradiculoneuropathy was made and treatment with human immunoglobulin was initiated for 5 days. Electroneuromyography showed peripheral, sensory-motor polyradiculoneuropathy and questioned the physiopathological possibility of juxtaparanodopathy. The patient presented a significant and early improvement after treatment. Conclusions: It is essential to consider that Guillain-Barré syndrome has symptom variability, especially according to its pathophysiology and clinical and electrophysiological variant, thus avoiding that conditions such as this one are underdiagnosed.

scholarly journals Guillain-Barré syndrome in a child with COVID-19 associated multi system inflammatory syndrome

2021 ◽  
Vol 8 (11) ◽  
pp. 1890
Author(s):  
Alekhya Erubothu ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar
Keyword(s):  
Axonal Neuropathy ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
High Grade Fever ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Paediatric Age ◽  
Guillain Barré ◽  
High Index Of Suspicion ◽  
Inflammatory Syndrome

Multi-system inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 is a new entity affecting a small percentage of children during the COVID-19 pandemic. This usually presents with multi-organ dysfunction, predominantly affecting cardiovascular, muco-cutaneous, and gastrointestinal systems. Till now, neurological manifestations as a part of this spectrum, such as, encephalopathy, inflammatory CNS syndromes, cerebrovascular disease, and Guillain-Barré syndrome (GBS), have been well reported in adults, but there is a paucity of data from the paediatric age group. Here, we present a case of a 6-year-old girl who presented to us with progressive, bilaterally symmetrical ascending weakness of lower limbs followed by upper limbs along with drooling of saliva and dyspnea. Nerve conduction studies showed motor axonal neuropathy suggestive of GBS and child was treated accordingly with intravenous immunoglobulin. On 4th day of admission, the child developed high grade fever spikes, hypotension and diarrhoea. Hence, worked up for MIS-C which revealed elevated inflammatory markers with positive SARS-CoV-19 IgM, IgG antibodies. The diagnosis was hence revised to GBS with MIS-C, the child was then started on methylprednisolone following which the child showed both clinical and biochemical improvement and was then discharged. A high index of suspicion for the possibility of MIS-C should be kept in mind in the present pandemic times, as the immune-mediated damages in MIS-C are potentially treatable with a timely institution of intensive care measures along with the use of steroids, IV-Ig, and plasmapheresis.

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