title: Guillan-Barré syndrome following scrub typus: two case reports.
abstract: Case 1: A 66-year-old man was admitted because of progressive gait disturbance and dysphagia after developing red rash. He was diagnosed as Guillain-Barré syndrome (GBS) and treated by intravenous immunoglobulin therapy (IVIg). Two weeks later, he could swallow and walk without any abnormalities. Case 2: A 58-year-old woman was admitted because of gait disturbance, bilateral peripheral facial nerve palsies, and respiratory failure one week after developing fever and rash. She was diagnosed as GBS and treated with IVIg. She underwent mechanical ventilation, while she could wean off it one month later and her limb strengths improved. We confirmed both patients had scrub typhus by serological studies. Peripheral neuropathy is one of the complications of scrub typhus. In addition, this disease sometimes leads to severe GBS. GBS should be included in differential diagnosis when peripheral neuropathies develop in the course of treating scrub typhus, and we should keep in mind that scrub typhus is one of the causes of GBS.
authors.affiliation: Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Sakai
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ishii
authors.forename: Yuka
authors.initials: Y
authors.lastname: Ebihara
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Mochizuki
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Shiomi
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Nakazato
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D020275:Guillain-Barre Syndrome / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000276:immunology; D012612:Scrub Typhus / Q000150:complications* / Q000175:diagnosis; D012698:Serologic Tests; D012720:Severity of Illness Index
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; D016756:Immunoglobulins, Intravenous