alexa Guillain Barre Syndrome Associated with Brucellosis: A Case Report and Review of the Literature | OMICS International| Abstract
E-ISSN: 2314-7326
P-ISSN: 2314-7334

Journal of Neuroinfectious Diseases
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  • Case Report   
  • J Neuroinfect Dis 2018, Vol 9(2): 277
  • DOI: 10.4172/2314-7326.1000277

Guillain Barre Syndrome Associated with Brucellosis: A Case Report and Review of the Literature

Sawsan Daoud*, Nouha Farhat, Hanen Haj Kacem, Olfa Hdiji, Salma Sakka, Mariem Damak and Chokri Mhir
Department of Neurology, Habib Bourguiba University Hospital, Tunisia
*Corresponding Author : Sawsan Daoud, Department of Neurology, Habib Bourguiba University Hospital, Route El-Ferdaous, CP 3029 - Sfax, Tunisia, Tel: +21621464680, Email: [email protected]

Received Date: May 28, 2018 / Accepted Date: Jun 18, 2018 / Published Date: Jun 27, 2018

Abstract

Introduction: Guillain-Barré syndrome (GBS) ranks as the most frequent cause of acute flaccid paralysis in the world. It is an autoimmune polyradiculoneuropathy, usually preceded by an acute infection. Rarely, brucellosis may induce a GBS.
Objective: To evaluate the clinical and microbiological diagnostic properties of Brucella-induced GBS.
Case Report: A 54-year-old woman, with no past medical history, was followed in infectious disease department. She was diagnosed with brucellosis. She had received antibiotic therapy (Rifampicin 600 mg/day and Doxycycline 200 mg/day). After 4 days of treatment, she was referred to our department because of rapidly progressive, ascending, symmetric weakness and bilateral paralysis of muscles of the face. On admission, she was alert. The deep tendon reflexes (DTRs) were absent in all extremities. Muscle strength was 3/5 in the upper extremities and 2/5 in the lower extremities. Proprioception in the lower extremities was impaired, but she did not have any sensory problems. Our patient also presented a facial diplegia. Physical examination was normal, except for splenomegaly. A lumbar puncture showed an albumin-cytologic dissociation in the CSF. Nerve-conduction studies were suggestive of demyelinating polyradiculoneuropathy. Coombs Wright titration was 1/160..
Discussion: With a diagnosis GBS preceded by brucellosis, our patient was given an antibiotic therapy (Rifampicin 600 mg/day and Doxycycline 200 mg/day). During hospitalization, she had four plasma exchange sessions and a motor rehabilitation. In a follow-up after 4 weeks, our patient presented a partial recovery, and she was able to walk without support.
Conclusion: This case demonstrates that brucellosis can present with a rare neurologic manifestation including GBS. Molecular mimicry seems to be responsible for this complication, through the synthesis of autoantibodies against myelin gangliosides. Thus, brucellosis should be ruled out in all patients who develop acute flaccid paralysis, especially in those who live in endemic areas.

Keywords: Brucellosis; Guillain-Barré syndrome; Neurobrucellosis

Citation: Daoud S, Farhat N, Kacem HH, Hdiji O, Sakka S, et al. (2018) Guillain Barre Syndrome Associated with Brucellosis: A Case Report and Review of the Literature. J Neuroinfect Dis 9: 277. Doi: 10.4172/2314-7326.1000277

Copyright: © 2018 Daoud S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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