Klinische und medizinische Fallberichte

Guillen-Barret Syndrome in a Patient with Leptospirosis

Abstract

Tina Deihim and Sahar Karimpour Reyhan

Introduction: leptospirosis is a zoonotic infection which is mostly transmitted with infected water. We report a case of Guillen-barret syndrome in adults associated with leptospirosis infection.

Case Description: A 59 years old, worker of water and Sewage Company, presented to emergency room with icter, ascending paraplegia and high creatinine level. He reported influenza like symptoms 2 weeks before his current presentation. Due to his work status and symptoms, leptospirosis infection was considered and patient received doxycycline in his treatment coarse. Patients symptoms and lab test has been better however weakness and reduced DTR was persistent. Cervical spine MRI reveals disc dehydration and protrusion in C5-6. However his symptoms, due to reducing DTR and ascending weakness were more consistent with Guillen batter syndrome. The patient received IVIG and the symptoms significantly reduced.

Discussion: Based on literature, the most common neurologic manifestation of leptospirosis is aseptic meningitis however there are some reports of mononeuritis multiplex, flaccid paraplegia and a Guillen-barret in pediatric. Our case is the first report of Guillen-barret in an adult with leptospirosis.