title: A 3-month-old baby with H1N1 and Guillain-Barré syndrome.
abstract: Majority of children with pandemic influenza A (H1N1)pdm09 experience mild illness with full recovery without treatment. A previously healthy two and a half month-old girl was admitted to our paediatric intensive care unit because of severe respiratory failure with A (H1N1)pdm09 infection. Despite initial clinical improvement all attempts to extubate to non-invasive ventilation were unsuccessful and 2 to 3 weeks after symptom onset she started periods of cardiovascular instability and a progressive neurological deterioration with distal symmetrical progressive motor weakness and areflexia. All investigations were normal except elevated liver enzymes and cerebrospinal fluid examination that revealed elevated protein without pleocytosis. A possible diagnosis of Guillain-Barré syndrome (GBS) was considered and electromyogram was compatible with axonal form of GBS. To our knowledge this is the youngest case of GBS acquired postnatally and the first in children associated with H1N1 virus.
authors.affiliation: Paediatrics Department, Hospital Prof Doutor Fernando Fonseca, Lisboa, Portugal. alexandravasc@gmail.com
authors.forename: Alexandra
authors.initials: A
authors.lastname: Vasconcelos
authors.forename: Francisco
authors.initials: F
authors.lastname: Abecasis
authors.forename: Rita
authors.initials: R
authors.lastname: Monteiro
authors.forename: Cristina
authors.initials: C
authors.lastname: Camilo
authors.forename: Marisa
authors.initials: M
authors.lastname: Vieira
authors.forename: Mamede
authors.initials: M
authors.lastname: de Carvalho
authors.forename: Manuela
authors.initials: M
authors.lastname: Correia
mesh_terms: D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000628:therapy / Q000821:virology*; D006801:Humans; D016756:Immunoglobulins, Intravenous; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000628:therapy / Q000821:virology*; D008279:Magnetic Resonance Imaging; D012121:Respiration, Artificial; D014140:Tracheotomy
chemical_list: D016756:Immunoglobulins, Intravenous