Multiple coinfections and Guillain Barré syndrome following outdoor travel to the American Northeast

William Farrington; Farzam Farahani; Kevin Garrett Tayon; Jaclyn Rudzinski; Mark Feldman; Kartavya Sharma

doi:10.1080/08998280.2023.2167049

Multiple coinfections and Guillain Barré syndrome following outdoor travel to the American Northeast

Proc (Bayl Univ Med Cent). 2023 Jan 25;36(3):386-388. doi: 10.1080/08998280.2023.2167049. eCollection 2023.

Authors

William Farrington¹, Farzam Farahani², Kevin Garrett Tayon¹, Jaclyn Rudzinski³, Mark Feldman¹, Kartavya Sharma²

Affiliations

¹ Department of Internal Medicine, Texas Health Dallas Presbyterian Hospital, Dallas, Texas.
² Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas.
³ North Dallas Pathology Services, Texas Health Dallas Presbyterian Hospital, Dallas, Texas.

Abstract

A 66-year-old immunocompetent man with preceding travel through the Northeastern United States developed Guillain-Barré syndrome. A broad search for infections revealed intraerythrocytic parasites on blood smear and positive polymerase chain reaction for Babesia microti; elevated IgM/IgG serologies for Ehrlichia chaffeensis; elevated IgM/IgG serologies and qualitative polymerase chain reaction for Epstein-Barr virus; and fecal culture growth of Arcobacter butzleri. In this report, we discuss the known or suspected association of these infectious agents with Guillain-Barré syndrome. This case also highlights the importance, in the setting of endemic exposure, of screening for multiple coinfections that can be transmitted by the same arthropod vector.

Keywords: Arcobacter; Epstein-Barr viremia; Guillain-Barre syndrome; babesiosis; enteritis; human monocytic ehrlichiosis; tick-borne illness.

Publication types

Case Reports