Rickettsia felis, West Indies

These included the lack of CSF albuminocytologic dissociation, the fact that the clinical signs occurred during the outbreak of pandemic (H1N1) 2009 virus infection rather than after it, and the fact that antibodies were not found in gangliosides. CSF albuminocytologic dissociation and serum ganglioside antibodies may be found in 85%–90% of Guillain-Barré syndrome patients (2). Alternatively, the patient might have had central nervous system complication from pandemic (H1N1) 2009 virus infection. Acute disseminated encephalomyelitis is a condition that might occur within 30 days after an infectious process (3). It can lead to quadriplegia and diffuse white matter lesions. The clinical feature that makes acute disseminated encephalomyelitis less likely in this patient was the CSF fi ndings in the reference range. In summary, however, we believe that pandemic (H1N1) 2009 virus infection can cause neurologic complications affecting both the peripheral and central nervous systems in adult patients.