Yang Gui-Hua, Wan Tu-Er, Song Hui-Ping, Song Hui-Wen
Department of Infectious Diseases, Sanming First Hospital Affiliated with Fujian Medical University, Sanming, China.
Department of Radiology, Sanming First Hospital Affiliated with Fujian Medical University, Sanming, China.
Am J Trop Med Hyg. 2025 Feb 25;112(5):1072-1076. doi: 10.4269/ajtmh.24-0623. Print 2025 May 7.
A 27-year-old man presented with a cough and progressive limb weakness. Initially diagnosed with pulmonary tuberculosis, he showed improvement in his cough after antituberculosis treatment (ATT). However, he subsequently developed worsening weakness and numbness in his lower limbs, leading to mobility loss and difficulty swallowing. A comprehensive diagnostic evaluation, including computed tomography of the lung, cranial magnetic resonance imaging, cerebrospinal fluid analysis, and electromyography, confirmed concurrent diagnoses of tuberculosis (TB) and Guillain-Barré syndrome (GBS). Treatment included immunoglobulin and corticosteroid therapy; however, his symptoms persisted, progressing to respiratory failure that required endotracheal intubation and plasma exchange therapy. After these interventions, his condition gradually improved, and he continued ATT, achieving a favorable recovery. A literature review identified 15 countries reporting cases of GBS associated with TB, with the highest incidence in India. Although most cases showed a positive prognosis, mortality rates were elevated in patients with comorbid TB and GBS compared to those with GBS alone.
一名27岁男性出现咳嗽和进行性肢体无力。最初被诊断为肺结核,抗结核治疗(ATT)后咳嗽有所改善。然而,他随后下肢无力和麻木加重,导致行动不便和吞咽困难。包括肺部计算机断层扫描、头颅磁共振成像、脑脊液分析和肌电图在内的全面诊断评估证实同时患有结核病(TB)和吉兰-巴雷综合征(GBS)。治疗包括免疫球蛋白和皮质类固醇治疗;然而,他的症状持续存在,进展为呼吸衰竭,需要气管插管和血浆置换治疗。经过这些干预后,他的病情逐渐改善,继续进行抗结核治疗,最终康复良好。文献综述发现有15个国家报告了与结核病相关的吉兰-巴雷综合征病例,印度的发病率最高。尽管大多数病例预后良好,但与单纯吉兰-巴雷综合征患者相比,合并结核病和吉兰-巴雷综合征患者的死亡率有所升高。