Comorbid Guillain-Barré Syndrome and Tuberculosis: A Case Study and Global Perspective.

Abstract

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.