Dados do Trabalho

Título

Urbanorum spp and Guillain-Barré Syndrome, a possible association?

RESUMO

Case report
A 57-year-old, white, male patient, previously without comorbidities, presented with diarrhea lasting four days, with aqueous content, without pathological products and with improvement after the use of symptomatic. After eight days, he started paresthesia in feet and legs evolving with paraparesis and needing support to walk.
On admission, the neurological examination revealed asymmetric tetraparesis of proximal predominance and areflex with Medical Research Council (MRC) with a total score of 24/60 and proteinocytological dissociation in cerebrospinal fluid.
Due to the neurological clinical condition and laboratory findings, the diagnosis of Guillain Barre syndrome was suggested. Electroneuromyography was performed with signs of acute motor neuropathy, of axonal pattern, compatible with motor axonal form (AMAN). Treatment with intravenous human immunoglobulin was then started on the third day of hospitalization at a dose of 0.4kg/kg/day for 05 days.
During hospitalization, abdominal distension associated with watery diarrhea was observed. Positive stool parasitological examination and visualized urbanorum ssp. with a positive fecal leukocyte test. In addition to the therapeutic approach of the syndrome, treatment for diarrhea secondary to urbanorum spp was also instituted with nitazoxanide for 07 days with improvement of abdominal distention and reduction of evacuation frequency.
Discussion
The high prevalence of parasites are sources of constant infections for the Brazilian population due to its territorial extension and precariousness in terms of basic sanitation. knowing the new incident parasites, their pathophysiology, virulence and possible associated diseases means that there are ways to combat and minimize the damage. A more detailed study of Urbanorum spp, its morphological structure and mainly, which drug therapy to use will bring uniformity of information and conduct. Awareness measures and basic hygiene care must be carried out to reduce transmissibility and reduce the incidence of the parasite.
Conclusion
We report the first case of clinical suspicion of a temporal association between Guillain-Barré syndrome and gastrointestinal tract disease caused by Urbanrum spp. Thus, seeking to alert about the probable relation of the parasite and the risk of development of GBS, as well as the pathophysiological mechanisms and treatment.

Palavras Chave

urbanorum spp ; enteroparasitoses ; Guillain-Barré syndrome