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Rio Grande Do Sul, Brazil: Two men hospitalized with undiagnosed paralysis - contact with horses reported

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  • Rio Grande Do Sul, Brazil: Two men hospitalized with undiagnosed paralysis - contact with horses reported

    Machine translation:

    Published Date: 24/08/2016 01:24:47
    Subject: PRO / PORT> neurological syndrome - Brazil (RS), human, unknown causes
    Archive Number: 20160824.4437440

    SYNDROME neurologically - BRAZIL (RIO GRANDE DO SUL), HUMAN CAUSES OPEN ENDED
    ************************************************** ******************************
    A message / Una mensaje / of ProMED-PORT
    ProMED is the largest publicly-available surveillance system conducting global reporting of infectious diseases outbreaks. Subscribe today.

    ProMED-mail and program / es un program de la
    International Society for Infectious Diseases
    The International Society for Infectious Diseases (ISID) brings together a network of individuals from around the world.


    Date: Tuesday, August 23, 2016
    Source: Alegrete All [21/08/2016] [edit]
    http://alegretetudo.com.br/dois-caso...na-santa-casa/

    Two rare and severe cases in the Holy House
    -------------------------------------------------- ---
    Two men are hospitalized in critical condition in the ICU of Santa Casa de Alegrete waiting bed in hospital in Porto Alegre, clinics or Conception, the two specialized to the stage where they are patients at this time.

    One of them, 38 with confirmed diagnosis of Guillain-Barr? syndrome, is in isolation. The other 30 years has similar symptoms and is being observable. The definitive diagnosis is not out yet.

    Both patients had direct contact with horses, one of them worked at the Jockey Club and the other as information, handler of horses [in the same place? - Mod RNA].. The 38 year old man is hospitalized since last Thursday (18) [August / 2016] and, more recently, on Saturday [20 / August / 2016], the second case (suspicious).

    Contact the Santa Casa, we were informed that the drug used in this treatment is the immunoglobulin, but is missing in the local Nursing Home and the region.

    Contact the ICU director, Jos? F?bio, he reported that there is still no precise diagnosis of what would be the cause, but is being evaluated the relationship of cases and transmission have been caused by tick [transmission of what? Virus? Bacterium? Toxin? - Mod RNA].. According to him, it is not ruled out this hypothesis [which hypothesis? Disease transmitted by ticks? What? - Mod RNA].. The isolation is due to the care the patient needs. The disease is not contagious [Guillain-Barr? syndrome is not contagious, but depending on the etiological agent, some viruses for example, may turn out to be capable of transmission person-person - Mod RNA.].

    In addition to the Guillain Barr? syndrome, one patient also has encephalitis, flaccid paralysis [unclear ... - Mod RNA.].

    -
    Reported by: ProMED-PORT http://www.promedmail.org/pt

    [Very confusing; inaccurate information. Information about person-time-place are scarce or absent.

    Patients have which type of bond, besides the fact that they had contact with horses? They work and / or reside in the same location? When sick? The neurological disorder was preceded by a specific clinical picture: diarrhea? Fever? Respiratory symptoms? Rash? There was exposure to any chemicals? They have recently been vaccinated? In their places of work, there was evidence of equine patients? Some other sick animal, including birds, bats ...? A history of having frequented area with arbovirus transmission of evidence? What is the real clinical syndrome: poliradiculopathy? Myelopathy? Encephalitis? Encephalomyelitis?

    What CSF standards, electromyography, radiological (CT and central nervous system resonance)? arboviruses, enteroviruses were surveyed? Discarded risk of infection by rabies virus? Campylobacter, Borrelia?

    Regarding the mentioned parasitism by ticks: it is a hypothesis or speculation, in fact, occurred? In both? What kind of tick? Parasitism in the workplace? How long before the onset of symptoms? Rickettsia, including those of the spotted fever group, can, in severe cases, be associated with neurological manifestations, especially encephalitis. However, as a rule, they are associated with other signs and symptoms, including fever and skin disorders (rash, petechiae or possibly sore at the site of inoculation).

    Hypothesis eventually to be considered, but, in general, difficult to prove, it is associated paralysis tick mediated neurotoxin.

    No clinical, laboratory and epidemiological more qualified, the list of potential agents / causes is enormous and therefore point the most likely diagnostic hypothesis would be close to speculation, bet.

    Additional information and opinions would be very welcome.

    - Mod RNA].
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