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Guillain-barré syndrome and tularemia pleuritis with high adenosine deaminase activity in pleural fluid

Guillain-Barré-Syndrom und Pleuritis mit hoher Adenosindesaminaseaktivität in der Pleuraflüssigkeit bei Tularämie

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Summary

A 56-year-old man suffered from prolonged fever, sore throat and cough, followed by pleural effusion and reversible progressive ascending muscle weakness. The condition fulfilled the diagnostic criteria of Guillain-Barré syndrome. Tuberculosis was initially suspected because of lymphocyte predominance and high adenosine deaminase activity in the pleural fluid. Later, an agglutination titer of 10,240 toFrancisella tularensis antigen was found and an infected hare exposure could be identified. Thus, the activity of adenosine deaminase may be high also in tularemia pleuritis.

Zusammenfassung

Ein 56 Jahre alter Mann litt an langanhaltenden Fieberzuständen, Halsschmerzen und Husten; in der Folge trat ein Pleuraexsudat auf und es entwickelte sich eine zunehmende aufsteigende Muskelschwäche, die sich als reversibel erwies. Der Zustand erfüllt die diagnostischen Kriterien für ein Guillain-Barré-Syndrom. Anfangs bestand Verdacht auf Tuberkulose, da sich in der Pleuraflüssigkeit vorwiegend Lymphozyten und eine hohe Adenosindesaminaseaktivität fanden. Später wurde ein Agglutinationstiter gegenFrancisella tularensis-Antigen von 10 240 entdeckt und Kontakt mit einem infizierten Hasen festgestellt. Hohe Adenosindesaminaseaktivität ist folglich auch bei der Tularämie-Pleuritis zu finden.

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Authors and Affiliations

  1. Departments of Internal Medicine and Medical Microbiology, University of Oulu, Oulu, Finland

    H. Syrjälä M.D.

  2. Department of Internal Medicine, University of Oulu, Oulu, Finland

    P. Kujala M.D.

  3. Department of Neurology, University of Oulu, Oulu, Finland

    V. Myllylä M.D.

  4. National Public Health Institute, Kuopio, Finland

    P. Koskela Ph.D.

Authors
  1. H. Syrjälä M.D.
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  2. P. Kujala M.D.
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  3. V. Myllylä M.D.
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  4. P. Koskela Ph.D.
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Syrjälä, H., Kujala, P., Myllylä, V. et al. Guillain-barré syndrome and tularemia pleuritis with high adenosine deaminase activity in pleural fluid. Infection 17, 152–153 (1989). https://doi.org/10.1007/BF01644015

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  • DOI: https://doi.org/10.1007/BF01644015

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