Scrub Typhus Associated with Guillain-Barré Syndrome (GBS)

Area of Science:

• Infectious Diseases
• Neurology
• Pediatrics

Background:

• Scrub typhus, caused by Orientia tsutsugamushi, is a vector-borne illness.
• Neurological complications like meningoencephalitis are known, but Guillain-Barré syndrome is exceptionally rare.

Purpose of the Study:

• To report an extremely rare case of Guillain-Barré syndrome secondary to scrub typhus in a child.
• To describe the clinical presentation, diagnostic findings, and successful treatment of this rare complication.

Main Methods:

• Case report of a 7-year-old boy presenting with fever and rapidly progressive quadriparesis.
• Etiological workup including serological tests for scrub typhus (positive IgM, high OXK titer).
• Nerve-conduction studies to evaluate peripheral neuropathy.

Main Results:

• The patient presented with ascending quadriparesis and areflexia.
• Diagnostic tests confirmed scrub typhus infection.
• Nerve-conduction studies indicated a demyelinating neuropathy consistent with Guillain-Barré syndrome.
• Complete recovery was achieved with intravenous immunoglobulin and azithromycin treatment.

Conclusions:

• Guillain-Barré syndrome is an extremely rare but possible neurological manifestation of scrub typhus.
• Prompt diagnosis and treatment with antibiotics and immunomodulatory therapy are crucial for favorable outcomes.
• This case underscores the importance of considering scrub typhus in the differential diagnosis of acute flaccid paralysis, especially in endemic areas.