From Kidneys to Nerves: A Rare Case of a Urinary Tract Infection Triggering Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) is an autoimmune disease typically caused by an acute viral illness that can lead to ascending paralysis. Rarely, GBS has been reported following an Escherichia coli urinary tract infection (UTI). A 68-year-old female with multiple comorbidities presented to the hospital for acute bilateral lower extremity weakness. She had been treated for a UTI one week prior. Clinical and radiologic evaluation were highly suggestive of GBS, although the patient declined confirmatory lumbar puncture. The patient recovered lower extremity function following a five-day course of intravenous immunoglobulin. Most interestingly, the patient returned to the emergency department on the day of discharge for chills, dizziness, and nausea and was found to have recurrent versus inadequately treated E. coli UTI. This case illustrates the importance of diagnostic consideration for infections less commonly associated with GBS. Additionally, the case highlights the need for concurrent treatment of ongoing infectious processes in addition to recommended immunotherapy.