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Guillain–Barré Syndrome After Zika Virus Infection in Brazil
Zika virus (ZIKV) is an emerging flavivirus, which has caused a widespread outbreak in the Americas. Shortly after its introduction in 2015, a cluster of cases with Guillain–Barré syndrome was detected in Brazil. Herein, we describe two cases from the city of Salvador, who developed ascending paresis after an acute exanthematous illness. The patients were admitted to the intensive care unit with tetraparesis and cranial nerve palsy, which resolved after intravenous administration of human immunoglobulin. Serological evaluation detected IgM-specific ZIKV antibodies. In regions of Zika virus transmission, health-care workers must be aware of the potential severe neurological complications associated with ZIKV infection and be prepared to provide prompt diagnosis, treatment, and supportive care.
Author Notes
Authors' addresses: Mateus Santana do Rosário, Centro de Pesquisas Gonçalo Moniz, Fundacao Oswaldo Cruz (FIOCRUZ), Salvador, Brazil, and Hospital Geral Roberto Santos, Secretaria de Saude do Estado da Bahia, Salvador, Brazil, E-mail: drmateusan@gmail.com. Pedro Antonio Pereira de Jesus and Daniel Santana Farias, Hospital Geral Roberto Santos, Secretaria de Saude do Estado da Bahia, Salvador, Brazil, E-mails: papj@terra.com.br and danielfarias1@hotmail.com. Nikos Vasilakis, Department of Pathology, Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, TX, E-mail: nivasila@utmb.edu. Marco Antônio Caires Novaes, Hospital São Rafael, Fundação Monte Tabor, Salvador, Bahia, Brazil, E-mail: macnovaes@yahoo.com.br. Sueli Guerreiro Rodrigues, Lívia Caricio Martins, and Pedro Fernando da Costa Vasconcelos, Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Belém, Brazil, E-mail: suelirodrigues@iec.pa.gov.br, liviamartins@iec.pa.gov.br, and pedrovasconcelos@iec.pa.gov.br. Albert Icksang Ko, Centro de Pesquisas Gonçalo Moniz, Fundacao Oswaldo Cruz (FIOCRUZ), Salvador, Brazil, and Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, E-mail: albert.ko@yale.edu. Luiz Carlos Junior Alcântara and Isadora Cristina de Siqueira, Centro de Pesquisas Gonçalo Moniz, Fundacao Oswaldo Cruz (FIOCRUZ), Salvador, Brazil, E-mails: lalcan@bahia.fiocruz.br and isadora.siqueira@bahia.fiocruz.br.