Integrated Approach to Severe Dengue Complicated by Guillain-Barré Syndrome and Multi-organ Failure.

ABSTRACT

This report details the case of a female patient who was admitted with severe dengue, which was further complicated by bilateral pneumonia and multiple organ involvement. The patient also developed quadriparesis, a neurological complication, and had a recent history of vaccination with the COVISHIELD COVID-19 vaccine. A nerve conduction study later determined the condition to be acute motor axonal neuropathy, a variant of Guillain-Barré syndrome (GBS). While neurological complications, such as GBS, are rare in dengue cases, they can significantly affect patient outcomes. Treatment with intravenous immunoglobulin (IVIG) has proven to be an effective disease-modifying therapy for GBS. IVIG therapy is recognized for its anti-inflammatory and immunomodulatory effects, making it beneficial in certain autoimmune conditions, including those involving the nervous system. However, its use in severe infections or sepsis remains controversial. In this case, IVIG therapy was administered alongside broad-spectrum antibiotics. The patient's favorable response to IVIG therapy and subsequent clinical improvement highlight the importance of early recognition and targeted intervention for neurological complications in dengue cases.