BMJ Case Reports 2012; doi:10.1136/bcr.12.2011.5462
  • Unusual association of diseases/symptoms

A 3-month-old baby with H1N1 and Guillain–Barré syndrome

  1. Manuela Correia2
  1. 1Paediatrics Department, Hospital Prof Doutor Fernando Fonseca, Lisboa, Portugal
  2. 2Pediatria – Unidade de Cuidados Intensivos Pediátricos, Hospital Santa Maria – Departamento da Criança e da Família – CHLN, Lisbon, Portugal
  3. 3Serviço de Pediatria, Hospital São Francisco Xavier-CHLO, Lisbon, Portugal
  4. 4Neurologia, Hospital Santa Maria – CHLN, Lisbon, Portugal
  1. Correspondence to Dr Alexandra Vasconcelos, alexandravasc{at}


Majority of children with pandemic influenza A (H1N1)pdm09 experience mild illness with full recovery without treatment. A previously healthy two and a half month-old girl was admitted to our paediatric intensive care unit because of severe respiratory failure with A (H1N1)pdm09 infection. Despite initial clinical improvement all attempts to extubate to non-invasive ventilation were unsuccessful and 2 to 3 weeks after symptom onset she started periods of cardiovascular instability and a progressive neurological deterioration with distal symmetrical progressive motor weakness and areflexia. All investigations were normal except elevated liver enzymes and cerebrospinal fluid examination that revealed elevated protein without pleocytosis. A possible diagnosis of Guillain–Barré syndrome (GBS) was considered and electromyogram was compatible with axonal form of GBS. To our knowledge this is the youngest case of GBS acquired postnatally and the first in children associated with H1N1 virus.


  • Competing interests None.

  • Patient consent Obtained.

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