A NEW ASSOCIATION OF GUILLAIN BARRE SYNDROME IN A PATIENT WITH CENTRAL NERVOUS SYSTEM MELIOIDOSIS

Authors

  • Ewe Jin Koh Department of Internal Medicine, Hospital Taiping
  • Kah Nian Tan Department of Internal Medicine, Hospital Taiping
  • Zhi Wei Chan Department of Internal Medicine, Hospital Taiping
  • Hoy Yan Candice Wong Department of Internal Medicine, Hospital Taiping
  • Ming Lee Chin Department of Medicine and Paediatrics
  • Tiong Chan Lee Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia

DOI:

https://doi.org/10.55519/JAMC-02-11470

Keywords:

Melioidosis, Peripheral nervous system, Acute flaccid paralysis, Anti-ganglioside antibodies, Guillain Barre sydrome

Abstract

Burkholderia pseudomallei affecting the central nervous system has been extensively reported in the literature. However, combined central nervous system and peripheral nervous system involvement in melioidosis has never been reported. We report a 66-year-old man with diabetes mellitus who was diagnosed to have central nervous system melioidosis and developed acute flaccid quadriplegia. Nerve conduction studies and anti-ganglioside antibodies were consistent with Guillain-Barre syndrome. This case report highlights the importance to recognise the possibility of Guillain Barre syndrome complicating central nervous system melioidosis and stresses the urgency of early consideration of this complication, as early immunomodulatory therapy may hasten neurological recovery.

Author Biographies

Ewe Jin Koh, Department of Internal Medicine, Hospital Taiping

Internal Medicine Specialist

Kah Nian Tan, Department of Internal Medicine, Hospital Taiping

Medical Officer

Zhi Wei Chan, Department of Internal Medicine, Hospital Taiping

Medical Officer

Hoy Yan Candice Wong, Department of Internal Medicine, Hospital Taiping

Medical Officer

Ming Lee Chin, Department of Medicine and Paediatrics

Specialist

Tiong Chan Lee, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia

Consultant Internal Medicine Physician

References

Currie BJ, Ward L, Cheng AC. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20-year Darwin prospective study. PLoS Negl Trop Dis 2010;4(11):e900.

Chang CY. Periorbital cellulitis and eyelid abscess as ocular manifestations of melioidosis: A report of three cases in Sarawak, Malaysian Borneo. IDCases 2020;19(e00683):e00683.

Wongwandee M, Linasmita P. Central nervous system melioidosis: A systematic review of individual participant data of case reports and case series. PLoS Negl Trop Dis 2019;13(4):e0007320.

Leonhard SE, Mandarakas MR, Gondim FAA, Bateman K, Ferreira MLB, Cornblath DR, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol 2019;15(11), 671–83.

Zhan Y, Wu Y, Li Q, Yu A. Neuromelioidosis: a series of seven cases in Hainan province, China. J Int Med Res 2017;45(2):856–67.

Wijekoon PWMCSB, Bandara KAS, Kailainathan A, Chandrasiri NS, Hapuarachchi CT. Guillaine-barre syndrome; a rare complication of melioidosis. a case report. BMC Infect Dis 2016;16(1):1–4.

Krovvidi R, Mridula RK, Jabeen SA, Meena AK. Guillain Barre syndrome as a manifestation of neurological melioidosis. Ann Indian Acad Neurol 2013;16(4):681–3.

bc-coordinator. Guillain Barré and Miller Fisher Syndromes: Case definition Companion Guide [Internet]. Brighton Collaboration. 2021 [cited 2022 Oct 16]. Available from: https://brightoncollaboration.us/guillain-barre-and-miller-fisher-syndromes-case-definition-companion-guide

Dabby R, Weimer LH, Hays AP, Olarte M, Latov N. Antisulfatide antibodies in neuropathy: clinical and electrophysiologic correlates. Neurology 2000;54(7):1448–52.

Hughes RAC, Wijdicks EFM, Barohn R, Benson E, Cornblath DR, Hahn AF, et al. Practice parameter: immunotherapy for Guillain-Barré syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2003;61(6):736–40.

Additional Files

Published

2023-04-17

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