Scrub Typhus Associated with Guillain-Barré Syndrome (GBS)

Indian J Pediatr. 2022 Nov;89(11):1129-1130. doi: 10.1007/s12098-022-04312-y. Epub 2022 Jul 26.

Abstract

Scrub typhus is a vector-borne disease caused by Orientia tsutsugamushi. Clinical manifestations generally occur due to vasculitis and inflammation and can have variable degrees of systemic involvement. Meningoencephalitis and cerebellitis are well-known neurological manifestations of scrub typhus, but the occurrence of Guillain-Barré syndrome is extremely rare. The authors report a 7-y-old boy who developed fever followed by rapidly progressive ascending quadriparesis with areflexia and whose etiological workup revealed positive IgM scrub typhus antibody, as well as, a high OXK titer (1:80). Nerve-conduction studies in all four limbs were suggestive of demyelinating neuropathy. He showed complete recovery after treatment with intravenous immunoglobulin (2 g/kg) and azithromycin.

Keywords: Guillain–Barré syndrome; Pediatric; Scrub typhus.

MeSH terms

  • Azithromycin / therapeutic use
  • Guillain-Barre Syndrome* / complications
  • Guillain-Barre Syndrome* / diagnosis
  • Humans
  • Immunoglobulin M
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Orientia tsutsugamushi*
  • Scrub Typhus* / complications
  • Scrub Typhus* / diagnosis
  • Scrub Typhus* / drug therapy

Substances

  • Immunoglobulin M
  • Immunoglobulins, Intravenous
  • Azithromycin