Two Filipino sisters from Capiz presented with facial muscle weakness followed by weakness of both shoulders and arms, and scapular winging. Both presented with difficulty in performing activities of daily living. The younger sister also had bilateral lower extremity weakness with difficulty in ambulation. The results of electrodiagnostic testing in both sisters were compatible with myopathic disease. Comprehensive individualized rehabilitation addressing different functional limitations, focusing on maintaining mobility and functional capacity, and resulting improvements are presented.

Human ; Female ; Adult ; Rehabilitation ; Activities Of Daily Living ; Lower Extremity ; Muscle Weakness ; Muscular Diseases ; Rhabdomyosarcoma, Alveolar ; Shoulder ; Siblings ; Upper Extremity ; Walking

Objective: To characterize two Achromobacter xylosoxidans recovered from 2 patients diagnosed with pertussis during a Bordetella pertussis surveillance program. Methods: Nasopharyngeal swabs from 2 children under 1 year of age with clinical suspicion of pertussis were analyzed by culture and PCR. Results: Two Achromobacter xylosoxidans A8, closely related to Bordetella spp. were recovered from 2 patients diagnosed of pertussis, both carrying the ptxA gene and IS418 the pertussis toxin encoding gene. Subsequently, antibiotic susceptibility was evaluated by disk-diffusion method and by PCR. Conclusions: Although more detailed studies are needed, the present data highlight the possibility that Achromobacter xylosoxidans, closely related Bordetella pertusssis microorganisms and not covered under the vaccine umbrella, might also result in cases of whooping cough. Thereby further surveillance is necessary to determine the extension and relevance of their pathogenic role in order to discriminate their real public health implication.