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Guillain-Barré Syndrome and Encephalitis Following a Cytomegalovirus Infection in an Immunocompetent Adult: A Case Report.
Araujo Coelho, David Richer; Melo Mendes, Isabel Cristina; Flores Mamani, Roxana; Oliveira da Luz, Rogerio; Martins de Oliveira, Ana Luiza; Pimentel, Clarisse.
Afiliação
  • Araujo Coelho DR; Instituto Estadual de Infectologia São Sebastião (IEISS), Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
  • Melo Mendes IC; Instituto Estadual de Infectologia São Sebastião (IEISS), Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
  • Flores Mamani R; Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
  • Oliveira da Luz R; Instituto Estadual de Infectologia São Sebastião (IEISS), Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
  • Martins de Oliveira AL; Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
  • Pimentel C; Plantão Interno, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
Am J Case Rep ; 25: e944337, 2024 Jul 18.
Article em En | MEDLINE | ID: mdl-39021063
ABSTRACT
BACKGROUND Cytomegalovirus (CMV) is a common herpesvirus that often causes asymptomatic or mild infections. In immunocompromised patients, CMV can lead to severe complications, including Guillain-Barre syndrome (GBS) and encephalitis. While these conditions have been described in the immunocompetent population, simultaneous presentation of CMV-associated GBS and encephalitis in such individuals has not been previously reported. CASE REPORT We present a case of a 58-year-old woman with poorly controlled diabetes who developed concurrent GBS and encephalitis following a CMV infection. The patient experienced bilateral ascending paraparesis 1 week after self-limited gastrointestinal symptoms. Despite initial treatment with plasma exchange therapy, her condition deteriorated with altered mental status and generalized tonic-clonic seizures, necessitating orotracheal intubation. Laboratory analysis revealed the presence of CMV in her cerebrospinal fluid. After treatment with further sessions of plasma exchange therapy and ganciclovir, her muscular strength in the extremities improved. However, she developed acute lung edema and failed extubation, leading to cardiorespiratory arrest with neurological sequelae. Palliative care was institutionalized, and she died 2 weeks later due to pneumonia. CONCLUSIONS This case highlights an unusual clinical presentation of overlapping CMV-associated GBS and encephalitis in an immunocompetent individual, with diabetes as the only identified risk factor. It underscores the importance of considering CMV as a potential etiological factor in such complex cases and the need for prompt diagnosis to improve patient outcomes. Further research is warranted to explore the underlying mechanisms and implications of this rare overlapping neurological manifestation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por Citomegalovirus / Síndrome de Guillain-Barré / Imunocompetência Limite: Female / Humans / Middle aged Idioma: En Revista: Am J Case Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por Citomegalovirus / Síndrome de Guillain-Barré / Imunocompetência Limite: Female / Humans / Middle aged Idioma: En Revista: Am J Case Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos