{"title":"Axonal Guillain-Barré Syndrome After Leptospirosis Contracted in a Cave or While Packrafting-A Case Report.","authors":"Roger B Mortimer, Donald J Iverson","doi":"10.1177/10806032251349730","DOIUrl":null,"url":null,"abstract":"<p><p>A 64-y-old male went caving and packrafting in Chiapas, Mexico. On return, he developed fever, headaches, and nausea and was treated empirically for leptospirosis with ceftriaxone and doxycycline. Convalescent IgM titers returned positive for leptospirosis. Other work-up was negative. As the symptoms of leptospirosis abated, the patient developed an areflexic quadriparesis. Nerve conduction velocities confirmed acute motor axonal neuropathy consistent with Guillain-Barré syndrome. Serologic work-up disclosed anti-GD1a antibodies. He was treated with intravenous immune globulin for 5 d and then did extensive rehabilitation. Three years after diagnosis, he is once again exploring caves.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251349730"},"PeriodicalIF":1.1000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wilderness & Environmental Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10806032251349730","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
A 64-y-old male went caving and packrafting in Chiapas, Mexico. On return, he developed fever, headaches, and nausea and was treated empirically for leptospirosis with ceftriaxone and doxycycline. Convalescent IgM titers returned positive for leptospirosis. Other work-up was negative. As the symptoms of leptospirosis abated, the patient developed an areflexic quadriparesis. Nerve conduction velocities confirmed acute motor axonal neuropathy consistent with Guillain-Barré syndrome. Serologic work-up disclosed anti-GD1a antibodies. He was treated with intravenous immune globulin for 5 d and then did extensive rehabilitation. Three years after diagnosis, he is once again exploring caves.
期刊介绍:
Wilderness & Environmental Medicine, the official journal of the Wilderness Medical Society, is the leading journal for physicians practicing medicine in austere environments. This quarterly journal features articles on all aspects of wilderness medicine, including high altitude and climbing, cold- and heat-related phenomena, natural environmental disasters, immersion and near-drowning, diving, and barotrauma, hazardous plants/animals/insects/marine animals, animal attacks, search and rescue, ethical and legal issues, aeromedial transport, survival physiology, medicine in remote environments, travel medicine, operational medicine, and wilderness trauma management. It presents original research and clinical reports from scientists and practitioners around the globe. WEM invites submissions from authors who want to take advantage of our established publication''s unique scope, wide readership, and international recognition in the field of wilderness medicine. Its readership is a diverse group of medical and outdoor professionals who choose WEM as their primary wilderness medical resource.