Dados do Trabalho

Título

DENGUE AND NEUROLOGICAL SYMPTOMS: AN ATYPICAL REPORT BY GUILLAIN BARRÉ AFTER DENGUE.

RESUMO

CASE PRESENTATION: a 52-year-old female patient, 17 days before the arrival of the service, with asthenia, cutaneous rash in thorax and bros, with diagnosis of dengue, evolved 11 days later with hypoesthesia and paresis of lower limbs (MMII) with ascence to upper limbs (MMSS), subsequently, the patient presented bilateral facial paresis and constipation. The patient presented Lucidity and well-oriented, with bilateral peripheral facial paralysis, with paresis and hyporeflexia of predominance in llll, also presented hyperalgesia of them. lumbar puncture showed protein dissociation and cellularity, with 10 mm3 of leukocytes, 95% leukocytes, 540.4 meq/l of protein and 72 mg/dl of glucose, with cervical resonance and cranial tomography without alterations and other general laboratory tests within the normal range. performed as human immunoglobulin treatment 5 g for 5 days. Before discharge, a new cerebrospinal fluid was performed, showing a fall in the protein, 350 meq/l and leukocytes, 4 mm3. After hospital discharge, the patient presented improvement of the picture with recovery of the strength pattern and improvement of facial paralysis. DISCUSSION: Guillain barré syndrome (sgb) is often associated with INFECTIONS BY CAMPYLOBACTER JEJUNI, CYTOMEGALOVIRUS, EPSTEIN–BARR VIRUS, MYCOPLASMA PNEUMONIA, hiv and the presence of association between arboviroses and sgb is well documented, mainly in relation to zika virus, however cases related to dengue. where only about 5% of the patients present with associated neurological symptoms, they are rare. The symptoms are closely related to infection where antigens stimulate the demyelination process, where most of the symptoms such as ascending paralysis, facial paralysis and areflexia. The only treatment with recognized and recommended clinical response is the application of human immunoglobulin, with a good response, and can be followed after application with prednisone, but with studies with inconclusive results, in the case presented, the patient had a clinical and laboratory condition compatible with the sgb, with a clear indication for immunoglobulin treatment. FINAL COMMENTS: The report shows a case of association between dengue infection and neurological symptoms, in which case the development of sgb is a rare presentation, with a good response to immunoglobulin treatment.

Palavras Chave

Dengue, Arboviruses, Guillian Barre