A rare co-occurrence of Guillain-Barré Syndrome and spinal tuberculosis: A case report

Introduction

The association of Guillain-Barré Syndrome (GBS) and spinal tuberculosis (TB) is rare. Sputum-positive pulmonary tuberculosis as a precipitant of GBS is a rare case report, even in developing countries like Ethiopia, where TB is common. We report a rare case of GBS and spinal TB in a 60-year-old Ethiopian male who experienced back pain and swelling, and bilateral lower extremity weakness. He struggled with bowel and urine control but had no history of head injury, vision blurring, or other medical issues. His neurological exam revealed gibbus deformity on his upper back and 0/5 power on his bilateral lower extremities. CSF analysis showed no cells, with a high protein count. Acute Inflammatory Demyelinating Polyneuropathy (AIDP) and T4/T5 Spondylodiscitis with the paravertebral collection were revealed on Nerve Conduction tests (NCTs), and Magnetic Resonance Imaging (MRI) respectively. The patient was diagnosed with GBS and spinal TB and started on anti-TB for 12 months with Prednisolone. He remained adherent, and he is now ambulating unaided and doing well. Due to financial challenges, intravenous immunoglobulin or plasmapheresis was not given as a treatment option for GBS.

Conclusion

We reported a rare case of GBS and TB, with the possibility of tubercular radiculomyelitis. The co-occurrence of spinal tuberculosis and GBS has been rare globally, and clinicians and researchers should consider tuberculosis as a potentially related illness.