Cukurova Med J GUILLAIN-BARRSYNDROME; EPSTEIN-BARR VIRUS AND COXSACKIE VIRUSES TYPE B COINFECTION

Abstract : BACKGROUND: Guillain-Barrsyndrome is an autoimmune peripheral neuropathy characterized by progressive symmetrical and ascending weakness and areflexia. Non-polio enterovirus (coxsackievirus type A and B, ECHO virus and enteroviruses) infections are seen in infants and children ranging from asymptomatic infection to life-threatening serious clinical conditions. Paralysis has been reported to be associated with coxsackievirus B2B6, enterovirus 71 and echovirus type 3, 4, 6, 9, 11, 19 and 22. Epstein-Barr virus is frequently involved in the etiology of aseptic meningitis, encephalitis, and Guillain-Barre syndrome. METHODS: A 22-month-old male patient with a diagnosis of Guillain-Barrsyndrome is presented due to an interesting and severe clinical course. RESULTS: Despite serious illness condition and prolonged intensive care treatment, the patient who was diagnosed with Guillain-Barrsyndrome with dual infectious etiology fully recovered with repeated intravenous immunoglobulin treatment. CONCLUSION: In the light of a case with concurrent detection of both etiological agents, we sought to draw attention on the presence of co-infection and non-polio enterovirus, albeit not reported, in GBS patients presenting rapid progression of clinical course with prolonged plateau phase and delayed clinical response.