Guillain Barré syndrome after occupational exposure. Report of a

Introduction
We report about a patient who developed Guillain- Barré syndrome(GBS) after occupational exposure to biohazardous material from an unknow source. 57 year old maid who worked in a pediatric hospital suffered a puncture wound with a hollow needle in the right hand. Anti hepatitis B vaccine and antireroviral medication (zivodune + lamivudine) was provided in time. In the first 48 hours, general muscle weakness, fatigue and headache began, which increased with each hour. Progressed in a few days with flaccid paresis of all limbs, dysarthria, and pulmonary ventilation disorders, swallowing disorder, diminished tendon reflexes in upper limbs, patellar and Aquilianos abolished, no meningeal signs, with signs of Constipation dysautonomic. Many supplementary examinastions are negative. Only was postitive the CSF with albumin-cytological dissociation (protein concentration 105 mg%, WBC 0) and EMG: Axon-myelin polyradiculoneuropathy After 5 days of hospitalization the treatment with plasmapheresis (5 sessions) and rehabilitation kinesiology began. The recovery was gradual with 75 days of hospitalization.

Methods
Report of a case.

Results
The temporal relationship and the absence of other causes suggest that hepatitis B vaccination may have been the triggering event of the SGB. The review of literature describes 20 cases of GBS associated with the HBV vaccine. Neurological side effects are a very rare occurrence. At the base of Reporting System Vaccine AdverseEvent, 101 cases of GBS following vaccination for HBV, have been recorded until 2003.

Discussion
History of infection within 28 days prior to the onset of symptoms occur in 50% of people with GBS, mainly respiratory infections or gastrointestinal tract. Between viruses and bacteria that have been implicated as triggers of GBS, the mostfrequent are: Enteroviruses, herpes family viruses, hepatitis A, B and C, HIV, Influenza, Measles,Brucella, Campylobacter, Listeria, Mycoplasma, Salmonella, Shigella and Yersinia. Vaccines that have been associated with GBS: rabies, meningococcal, anti Influenza, Sabin and others.