Campylobacter coli infection causes spinal epidural abscess with Guillain-Barré syndrome: a case report

Abstract

Background: 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.

Case presentation: 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.

Conclusions: 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.

Keywords: Anti-ganglioside antibodies; Bacterial infection; acute motor sensory axonal neuropathy; paralysis; Campylobacter coli; Guillain–Barré syndrome; Spinal epidural abscess.

Fig. 1

Lumbar magnetic resonance imaging. a Sagittal lumber T2-weighted images show a high signal intensity at the L5-S1 vertebral disc, indicating an epidural abscess (arrow). b Axial T2-weighted images reveal abscess at the L5 disc (arrow)