title: Acute quadriplegia complicating critical illness polyneuropathy in a patient with infective endocarditis: a case report.
abstract: A 75-year-old woman with infective endocarditis developed critical illness polyneuropathy (CIP) with quadriplegia after cardiac surgery. The quadriplegia resolved gradually after aggressive treatment of the underlying infection and with rehabilitation. However, a MEDLINE search of the English-language literature failed to yield results matching quadriplegia and infective endocarditis. CIP is a complication of septic syndrome and sepsis. This complication has been largely unrecognized in intensive care units owing to difficulties in performing a clinical examination or electrophysiologic studies. Difficulty in weaning from the ventilator is an important early manifestation of CIP. Electroneuromyography (ENMG) should be routinely performed to establish the diagnosis. We suggest that any septic patients with unexplained muscle weakness, paralysis, or difficulty in weaning from the ventilator should be evaluated for CIP.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, ROC.
authors.forename: Hsiang-Cheng
authors.initials: HC
authors.lastname: Chen
authors.forename: Chien-Sung
authors.initials: CS
authors.lastname: Tsai
authors.forename: Jiunn-Tay
authors.initials: JT
authors.lastname: Lee
authors.forename: Chuu-An
authors.initials: CA
authors.lastname: Chen
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D000368:Aged; D016638:Critical Illness; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000382:microbiology; D005260:Female; D006801:Humans; D011115:Polyneuropathies / Q000150:complications*; D011782:Quadriplegia / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification