Disclosures: Barthelemy Liabaud, MD: Nothing to disclose

Case Description: The patient’s labor was complicated by a chorioamnionitis with E. coli, which was treated with an emergent C-section and antibiotics. The patient developed multiple complications leading to cardiac arrest. In the post ICU setting she progressively presented with peripheral weakness, worse in the bilateral lower extremities. The weakness progressed rapidly to flaccid quadriparesis with hyporeflexia and severe sensorimotor polyneuropathy. The EMG findings were suggestive of an AMAN. Upon admission to acute rehabilitation the patient was quadriparetic and areflexic. The patient never developed saddle anesthesia, urinary retention nor fecal or urinary incontinence, nor shortness of breath.

Setting: Tertiary care hospital

Patient: 23-year-old Gravida 1 Para 0 Hispanic female with no past medical history.

Assessment/Results: She was started on a course of immunoglobulin therapy and IV steroids for 6 weeks. Her quadriparesis improved slightly after the infusion of immunoglobulins. Upon discharge from acute rehabilitation, approximately 3.5 months from initial symptoms, the patient was still not ambulatory and maximum assist with transfers, but she had regained some distal strength and was able to move her upper and lower extremities with gravity eliminated. She had improved trunk balance and was able to maintain static sitting at the edge of the bed and type on a keyboard.

Discussion:  The patient presented with chorioamnionitis which is among the most common causes of sepsis in the pregnant patients in the U.S., with E. coli being the most common responsible pathogen. The course of her chorioamnionitis was complicated by sepsis and DIC and ultimately by an AMAN.

Conclusion: This case is documenting the development of a post infectious acute motor axonal neuropathy occurring after an E. coli sepsis which has to our knowledge never been described in the literature. Most described cases have antecedent infection with Campylobacter jejuni.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/acute-motor-axonal-neuropathy-following-e-coli-chorioamnionitis-a-case-report/