쯔쯔가무시병 후에 발생한 길랑- 바레 증후군 2예 - 증례 보고 -
Two Cases of Guillain-Barre′Syndrome Following Scrub Typhus - A Case Report -
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Scrub typhus is an acute febrile zoonosis caused by Orientia tsusugamushi, which is transmitted by the infected trombiculid mites. Infections by virulent strains are characterized by fever, rash, eschar, pneumonia, myocarditis and disseminated intravascular coagulation. But peripheral nerve system involvement in scrub typhus is rare. We report two cases of Guillain-Barre′syndrome (GBS) associated with scrub typhus, who initially presented with fever, rash, eschar and responded to doxycyclin. The serological data confirmed the diagnosis of scrub typhus. Two patients later developed ascending progressive weakness that involved both lower and upper extremities. The neurologic examination, cerebrospinal fluid and electromyography studies were compatible with GBS.
Abstract
Scrub typhus is an acute febrile zoonosis caused by Orientia tsusugamushi, which is transmitted by the infected trombiculid mites. Infections by virulent strains are characterized by fever, rash, eschar, pneumonia, myocarditis and disseminated intravascular coagulation. But peripheral nerve system involvement in scrub typhus is rare. We report two cases of Guillain-Barre′syndrome (GBS) associated with scrub typhus, who initially presented with fever, rash, eschar and responded to doxycyclin. The serological data confirmed the diagnosis of scrub typhus. Two patients later developed ascending progressive weakness that involved both lower and upper extremities. The neurologic examination, cerebrospinal fluid and electromyography studies were compatible with GBS.
참고문헌 (10)
- Govoni V, "Epidemiology of the Guillain-Barre′syndrome", Current Opinion in Neurology, 14, pp.605~613 (2001)
- Hadden RD, "Preceding infections, immune factors, and outcome in Guillain-Barre′syndrome", Neurology, 56, pp.758~765 (2001)
- Seong SY, "Orientia tsutsugamushi infection: overview and immune responses", Microbes Infect, 3, pp.11~21 (2001)
- Jeong YJ, "Scrub typhus: clinical, pathologic, and imaging findings", Radiographics, 27, pp.161~172 (2007)
- Silpapojakul K, "Rickettsial meningitis and encephalitis", Arch Intern Med, 151, pp.1753~1757 (1991)
- Lee SH, "Guillain-Barre′syndrome associated with scrub typhus", Scand J Infect Dis, 39, pp.826~828 (2007)
- Pai HJ, "Central nervous system involvement in patients with scrub typhus", Clin Infect Dis, 24, pp.436~440 (1997)
- Gorson KC, "Vasculitic neuropathies: an update", Neurologist, 13, pp.12~19 (2007)
- Winer JB, "HLA antigens in the Guillain-Barre′syndrome", Neuroimmunol, 18, pp.13~16 (1988)
- Hughes RA, "Pathogenesis of Guillain-Barre′syndrome", J Neuroimmunol, 100, pp.74~97 (1999)