Miljković-Selimović Biljana, Lavrnić Dragana, Morić Olga, Ng Lai-King, Price Lawrence, Suturkova Ljubica, Kocic Branislava, Babić Tatjana, Ristić Ljiljana, Apostolski Slobodan
Department of Microbiology and Immunology, School of Medicine, University of Nis, Bul Dr Z Dindića, 81, 18000 Nis, Serbia.
J Med Case Rep. 2010 Mar 31;4:101. doi: 10.1186/1752-1947-4-101.
Campylobacter species represent the main cause of bacterial diarrhea in developed countries and one of the most frequent causes of enterocolitis in developing ones. In some patients, Campylobacter jejuni infection of the gastrointestinal tract has been observed as an antecedent illness of acute motor axonal neuropathy, a variant of Guillain-Barré syndrome.
We present a case of acute motor axonal neuropathy following infection with Campylobacter jejuni subspecies jejuni, biotype II, heat stable serotype O:19. A 46-year-old Caucasian man developed acute motor neuropathy 10 days after mild intestinal infection. The proximal and distal muscle weakness of his upper and lower extremities was associated with serum antibodies to Campylobacter jejuni and antibodies to ganglioside GM1. The electromyographic signs of neuropathic muscle action potentials with almost normal nerve conduction velocities indicated axonal neuropathy. Our patient's clinical and electrophysiological features fulfilled criteria for the diagnosis of an acute motor axonal neuropathy, a subtype of Guillain-Barré syndrome.
As this is the first case of acute motor axonal neuropathy following infection with Campylobacter jejuni subspecies jejuni reported from the Balkan area, the present findings indicate the need for systematic studies and further clinical, epidemiological and microbiological investigations on the prevalence of Campylobacter jejuni and its heat stable serotypes in the etiology of Guillain-Barré syndrome and other post-infectious sequelae.
弯曲杆菌属是发达国家细菌性腹泻的主要病因，也是发展中国家最常见的小肠结肠炎病因之一。在一些患者中，空肠弯曲菌胃肠道感染被观察到是急性运动轴索性神经病（格林-巴利综合征的一种变体）的前驱疾病。
我们报告一例空肠弯曲菌空肠亚种生物2型、热稳定血清型O:19感染后发生急性运动轴索性神经病的病例。一名46岁的白种男性在轻度肠道感染10天后出现急性运动神经病。他上下肢近端和远端肌肉无力，伴有抗空肠弯曲菌血清抗体和抗神经节苷脂GM1抗体。神经肌肉动作电位的肌电图表现为神经传导速度几乎正常，提示轴索性神经病。我们患者的临床和电生理特征符合急性运动轴索性神经病（格林-巴利综合征的一种亚型）的诊断标准。
由于这是巴尔干地区首例报告的空肠弯曲菌空肠亚种感染后发生急性运动轴索性神经病的病例，目前的研究结果表明，需要对空肠弯曲菌及其热稳定血清型在格林-巴利综合征和其他感染后后遗症病因中的流行情况进行系统研究以及进一步的临床、流行病学和微生物学调查。
