First reported case of respiratory syncytial virus infection causing guillain–Barré syndrome

• DOI: 10.4103/ijccm.ijccm_171_17
• Publication Date: 2018-04-18T07:01:46Z
• Authors: Scott Helgeson; Alexander Heckman; Dana Harris
• Keywords: Respiratory infection

Case Report IntroductIonAcute immune-mediated polyneuropathies, also known as Guillain-Barre syndrome (GBS), are a group of illnesses that cause some forms paralysis following an infection.This infection invokes immune response cross-reacts with peripheral nerves. [1]The most common GBS is Campylobacter jejuni. [2]We report case elderly woman respiratory syncytial virus (RSV) who developed GBS.To the best our knowledge, has never been reported to be preceded by RSV infection. reportAn 81-year-old female history multiple myeloma currently undergoing treatment dexamethasone and zoledronic acid, breast cancer treated 5 years prior lumpectomy radiation therapy now in remission, hypertension, hypothyroidism was admitted for 7-day cough, runny nose, sore throat.She denied fever, shortness breath, chest pain, skin rashes, abdominal diarrhea.On physical examination, patient tachypneic, no pharyngeal erythema, tonsil exudates, or accessory muscle use.Lungs were clear auscultation rashes.Laboratories notable white blood cell count 15.1 × 10 9 /L, 95% segmented neutrophils, bicarbonate 17 mmol/L, lactate 1.5 procalcitonin 0.28 ng/mL.Chest radiograph showed consolidations.Computed tomography left lower right lobe small airway disease [Figure 1].RSV polymerase chain reaction from nasopharyngeal swab positive.On admission, required 2 L oxygen nasal cannula, but on hospital day 2, her requirements increased she high-flow oxygen.Ribavirin started at dose 600 mg twice daily orally.The eventually transferred Intensive Care Unit intubated distress.She extubated 4 days later, bilateral extremity weakness absent deep tendon reflexes noted examination.The paresthesias feet.This progressed, over course 24 h, upper extremities involved.Laboratory investigations this time normal electrolytes, complete differential, procalcitonin; alkaline phosphatase 62 U/L, alanine aminotransferase 22 aspartate 57 creatine kinase 198 U/L.A bedside lumbar puncture attempted unsuccessful.Acute polyneuropathies infection.We describe one these being caused (RSV).An infection.She went into failure requiring intubation mechanical ventilation ribavirin.When extubated, had reflexes.Her progressed rapidly involve diaphragm, eventually, family agreed let natural death process occur.Our first which acute polyneuropathy