Two Cases of Scrub Typhus Presenting with Guillain-Barré Syndrome with Respiratory Failure

Ju, Il Nam; Lee, Jung Woo; Cho, Sung Yeoun; Ryu, Seung Jee; Kim, Youn Jeong; Kim, Sang Il; Kang, Moon Won

doi:10.3904/kjim.2011.26.4.474

Cited by 19 publications

(23 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At 48 days after admission, his manual muscle testing grade recovered to normal, and he was discharged without complications. [32] Lee et al described Guillain-Barré syndrome (GBS) associated with scrub typhus. The diagnosed of GBS was based on neurological examination and electromyography.…”

Section: Clinical Featuresmentioning

confidence: 99%

Neuropsychiatric Manifestations of Scrub Typhus

Mahajan¹,

Mahajan

2017

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

Scrub typhus is caused by Orientia tsutsugamushi characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. It was thought to have been eradicated from India. Recently it is being reported from many areas of India. The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are not uncommon but are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillan-Barré syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhus is limited to case reports mainly. This article reviews various neurological manifestations of scrub typhus reported in literature.

show abstract

Section: Clinical Featuresmentioning

confidence: 99%

Neuropsychiatric Manifestations of Scrub Typhus

Mahajan¹,

Mahajan

2017

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

show abstract

“…[7][8] The triad of features of fever, lymphadenopathy and eschar should raise a suspicion of Scrub typhus especially during the season. 9 We should look out for other complications like acute kidney injury, 7 septic shock, 10 respiratory failure 11 and Guillain-Barre Syndrome. 11 GBS secondary to scrub typhus is suspected to be due to a phenomenon called molecular mimicry, which is cross reactivity between the host's myelin cells or peripheral nerve axons with O. tsutsugamushi antibody or antigens presented on infected cells.…”

Section: Discussionmentioning

confidence: 99%

“…It is confirmed by GD1b and GM1 IgM anti-glucoside antibodies in serum. 11 This might as well apply to any neurological tissue involved.…”

Section: Discussionmentioning

confidence: 99%

A Rare Presentation of Scrub Typhus as Adem

Rajesekar¹,

Abitha²,

Ameen³

2017

jemds

View full text Add to dashboard Cite

BACKGROUND A young male presented with fever, chills, neck rigidity, unsteadiness and abdominal pain. Patient had signs of chorea (hung-up reflex, exaggerated abdominal reflex), signs of meningoencephalitis (Kernig's positive, opsoclonus) generalised lymphadenopathy (involving cervical, inguinal & axillary regions)-tender & matted, eschar in right inguinal region, left UMN type of facial nerve palsy, signs of pyramidal tract (exaggerated deep tendon reflexes, right plantar extensor), signs of extrapyramidal tract (cog-wheel rigidity) and signs of cerebellar signs (hypotonia & stance and gait ataxia) were present bilaterally giving a picture of Acute Disseminated Encephalomyelitis (ADEM). ELISA for scrub typhus IgM was positive after ruling out malaria, dengue, leptospirosis, bacterial, viral and TB meningitis. ADEM is most rare and deadly presentation of Scrub typhus.

show abstract

“…Based on a literature review and consultation with the clinician panel, we found that several conditions are known to cause GBS [18]. These include upper respiratory infection [18][19][20][21], gastrointestinal disorders [18][19][20]22], Zika/Dengue infection [23], Malaria infection [24,25], Tsutsugamushi infection [26], surgery history [27,28], campylobacter infection [29][30][31][32][33][34], cytomegalovirus infection [33][34][35][36][37][38], Epstein-Barr virus infection [33,[38][39][40][41], herpes simplex virus [39], varicella-zoster virus infection [42], mycoplasma pneumonia infection [43,44], haemophilus influenza infection [18,45], and influenza virus infection [46,47]. For each condition, the checklist asks whether the patient had the condition prior to the manifestation of GBS.…”

Section: Checklistmentioning

confidence: 99%

Causality Assessment Guidelines for Adverse Events Following Immunization with a Focus on Guillain–Barré Syndrome

et al. 2020

View full text Add to dashboard Cite

South Korea operates a National Vaccine Injury Compensation Program (VICP) for people who experience adverse events following immunization (AEFI). To run this program rationally, it is a prerequisite to confirm whether adverse events were caused by immunization. Guillain–Barré syndrome (GBS), a severe neurological disease with limb pain and muscle weakness as cardinal symptoms, is attracting attention as an AEFI. However, algorithm or guidelines for assessing the causality between vaccination and the incidence of GBS are lacking. We aimed to develop guidelines for causality assessment of GBS as an AEFI and suggest using these guidelines in alignment with the VICP. We systematically searched for other previously published algorithms or guidelines and found a WHO-AEFI guideline used worldwide; however, it only provides general instructions and is not tailored to specific adverse events. We translated and locally adapted the structure of this guideline and then added contents related to GBS. The GBS-specific guideline consists of four steps: case ascertainment of GBS, checklist (including (1) order of incidence, (2) temporal proximity, (3) evidence for other causes and (4) published evidence), an algorithm, and final classification. We listed key information on confirming GBS and whether any other causes of GBS were present. For real world application of the guideline along with the VICP, we collaborated with a panel of neurologists, epidemiologic investigators, and committee members from the VICP. To ensure transparency and a scientific approach, regular updates and collaboration with neurologists are essential. We expect that this guideline will contribute to logical causality assessment and compensation decisions for GBS and will provide the basic structure for causality assessment of other AEFIs.

show abstract

Two Cases of Scrub Typhus Presenting with Guillain-Barré Syndrome with Respiratory Failure

Cited by 19 publications

References 5 publications

Neuropsychiatric Manifestations of Scrub Typhus

Neuropsychiatric Manifestations of Scrub Typhus

A Rare Presentation of Scrub Typhus as Adem

Causality Assessment Guidelines for Adverse Events Following Immunization with a Focus on Guillain–Barré Syndrome

Contact Info

Product

Resources

About