SIADH is a common and important electrolyte disorder encountered in GBS. It has significant association with severity of GBS and is an indicator of poor prognosis. It can be symptomatic even though the majority of patients are asymptomatic.
Scrub typhus is a rickettsial disease caused by Orientia tsutsugamushi, one of the most common infectious diseases in the Asia-Pacific region. It has been reported from northern, eastern, and southern India, and its presence has been documented in at least 11 Indian states. However, scrub typhus meningoencephalitis has not been well documented in Kerala. We report two cases of scrub typhus meningoencephalitis from northern Kerala. The diagnosis was made based on the clinical pictures, presence of eschar, and a positive Weil–Felix test with a titer of > 1:320. The first patient succumbed to illness due to respiratory failure and the second patient improved well.
ChAdOx1 nCoV‐19 is an effective and well‐tolerated coronavirus disease 2019 (COVID‐19) vaccine. Rare cases of serious adverse events have been reported with this vaccine. We report three patients who developed Guillain‐Barré syndrome following ChAdOx1 nCoV‐19 vaccination, who did not have active or prior COVID‐19 infection. The neurological illness in all patients had an onset of 11‐13 days after the first dose of vaccine. All were characterized by sensorimotor weakness of the upper and lower limbs, with facial diplegia in one and dysautonomia in the other. Nerve conduction studies were consistent with demyelination in two and axonopathy in one. Cerebrospinal fluid analysis showed albuminocytological dissociation in two patients. All patients had moderate‐to‐severe disability. They were treated with intravenous immunoglobulin, with stabilization of the disease. Proper monitoring and prompt reporting of such cases is required to ensure safety of the vaccine.
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