Variables | Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 | Patient 7 | Patient 8 | Patient 9 | Patient 10 | Patient 11 | Patient 12 | Patient 13 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Demographics | |||||||||||||
Age (years) | 34 | 20 | 25 | 22 | 22 | 28 | 43 | 21 | 20 | 23 | 29 | 25 | 18 |
Gender | F | M | M | F | M | F | M | F | M | M | F | M | M |
Nationality | Philipino | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi | Saudi |
Weight (kgs) | 60 | 71 | 116 | 71 | 73 | 60 | 85 | 81 | 80 | 78 | 120 | 55 | 66 |
Co-morbidities | Mild scoliosis | None | Obesity | None | None | None | Smoker/ diabetic | None | Smoker | None | Obesity/asthma | Gilbert syndrome | Bronchial asthma |
Presentation (year 2024) | |||||||||||||
Possible source | Source-1 | Source-1 | Source-1 | Source-1 | Source-1 | Source-2 | Source-1 | Source-2 | Random | Random | Random | Source-2 | Random |
Date of exposure | April 14 | April 21 | April 23 | April 25 | April 25 | April 24 | April 25 | April 26 | April 30 | April 30 | April 30 | April 30 | May 4 |
Onset of symptoms | April 17 | April 22 | April 24 | April 25 | April 26 | April 25 | April 26 | April 27 | April 30 | May 1 | May 1 | May 2 | May 4 |
ER presentation | April 18 | April 23 | April 24 | April 26 | April 27 | April 28 | April 28 | April 29 | April 30 | May 1 | May 1 | May 2 | May 5 |
RRT activation | April 20 | April 23 | April 24 | April 26 | None | April 28 | April 28 | April 29 | April 30 | May 1 | May 1 | May 2 | May 5 |
Clinical features | |||||||||||||
Dyspghagia | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||
Visual symptoms* | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||
Speech symptoms | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||||
UL weakness | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||
LL weakness | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||||
Respiratory symptoms | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||||
GI symptoms | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | |||||
Headach | ✔︎ | ✔︎ | ✔︎ | ||||||||||
Dizziness | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||||||
Days from presentation to diagnosis | 7 | 3 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Differential diagnosis | GBS | MG/GBS | MG | GBS | GBS | GBS | |||||||
IVIG | |||||||||||||
IVIG given | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ||||||
Improvement after IVIG | ✔︎ | ✔︎ | |||||||||||
Antitoxin | |||||||||||||
Days from presentation to antitoxic | 7 | 3 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Improvement after antitoxin | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | |
Adverse reactions to antitoxin | None | None | None | None | None | None | None | None | None | None | None | None | None |
3,4-DAP | |||||||||||||
Days from presentation to 3,4-DAP | 7 | 3 | 4 | 1 | None | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Improvement after 3,4-DAP | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | |||
Adverse reactions to 3,4-DAP | None | HTN | Tachycardia/HTN | None | - | None | None | None | None | None | None | None | None |
Severity and outcome | |||||||||||||
MV | ✔︎ | ||||||||||||
NIV | ✔︎ | ||||||||||||
HFNC | ✔︎ | ✔︎ | |||||||||||
ICU LOS (days) | 5 | Still in ICU | 9 | 9 | 0 | 8 | 2 | 3 | 2 | 4 | 3 | 2 | 2 |
Discharged | ✔︎ | Still in ICU | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | ✔︎ | In rehab | ✔︎ | ✔︎ | ✔︎ |
Hospital LOS (days) | 19 | Still in ICU | 13 | 10 | 2 | 10 | 6 | 6 | 2 | In rehab | 4 | 3 | 2 |
↵* Visual symptoms include: ptosis, double vision and blurring of vision.
M: male, F: female, ER: emergency room, RRT: rapid response team, UL: upper limb, LL: lower limb, GI: gastrointestinal, GBS: Guillain-Barré syndrome, MG: myasthenia gravis, IVIG: intravenous immunoglobulin, 3,4-DAP: 3,4-diaminopyridine, HTN: hypertension, MV: mechanical ventilation, NIV: non-invasive ventilation, HFNC: high flow nasal cannula, ICU: intensive care unit, LOS: length of stay, rehab: rehabilitation