Department of Neurology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori, 030-8551, Japan.
Department of Infection Control Office, Aomori Prefectural Central Hospital, Aomori, Japan.
BMC Neurol. 2022 Jan 3;22(1):9. doi: 10.1186/s12883-021-02537-6.
Guillain-Barré syndrome (GBS) and spinal epidural abscess (SEA) are known as mimics of each other because they present with flaccid paralysis following an infection; however, they differ in the main causative bacteria. Nevertheless, the two diseases can occur simultaneously if there is a preceding Campylobacter infection. Here, we report the first case of SEA with GBS following Campylobacter coli infection.
A 71-year-old Japanese man presented with progressive back pain and paralysis of the lower limbs following enteritis. Magnetic resonance imaging showed a lumbar epidural abscess that required surgical decompression; therefore, surgical drainage was performed. Blood cultures revealed the presence of C. coli. Despite surgery, the paralysis progressed to the extremities. Nerve conduction studies led to the diagnosis of GBS. Anti-ganglioside antibodies in the patient suggested that GBS was preceded by Campylobacter infection. Intravascular immunoglobulin therapy attenuated the progression of the paralysis.
We report a case of SEA and GBS following Campylobacter infection. A combination of the two diseases is rare; however, it could occur if the preceding infection is caused by Campylobacter spp. If a cause is known but the patient does not respond to the corresponding treatment, it is important to reconsider the diagnosis based on the medical history.
格林-巴利综合征（GBS）和脊髓硬膜外脓肿（SEA）被认为彼此相似，因为它们在感染后都会出现弛缓性瘫痪；然而，它们的主要致病细菌不同。尽管如此，如果存在先前的弯曲杆菌感染，这两种疾病仍可能同时发生。在此，我们报告首例大肠弯曲杆菌感染后继发 SEA 和 GBS 的病例。
一名 71 岁的日本男性因肠炎后出现进行性背痛和下肢瘫痪而就诊。磁共振成像显示腰椎硬膜外脓肿需要手术减压；因此，进行了手术引流。血培养显示存在 C. coli。尽管进行了手术，瘫痪仍进展至四肢。神经传导研究提示诊断为 GBS。患者抗神经节苷脂抗体提示 GBS 之前存在弯曲杆菌感染。静脉内免疫球蛋白治疗减轻了瘫痪的进展。
我们报告了一例大肠弯曲杆菌感染后继发 SEA 和 GBS 的病例。两种疾病同时发生的情况较为罕见；然而，如果先前的感染是由弯曲杆菌属引起的，则可能会发生这种情况。如果已知病因但患者对相应治疗无反应，则根据病史重新考虑诊断非常重要。
