Guillain-Barré Syndrome Following an Extended-Spectrum Beta-Lactamase Escherichia coli Urinary Tract Infection: A Case Report

Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that typically develops after a respiratory or gastrointestinal infection. While Campylobacter jejuni is associated with approximately 30% of cases, organisms such as Haemophilus influenzae, Mycoplasma pneumonia, Epstein-Barr virus, cytomegalovirus, Zika virus, influenza virus, and hepatitis A, B, C, and E have demonstrated clinical associations to GBS. In rare instances, Escherichia coli infections have been documented as the underlying cause for GBS. Our patient, a 69-year-old female, was admitted with a two-week history of progressively worsening bilateral lower extremity weakness following diagnosis of an extended-spectrum beta-lactamase E. coli urinary tract infection. She was diagnosed with GBS based on acute flaccid paralysis, areflexia, and a nerve conduction velocity study showing an absent motor response in her lower extremities bilaterally. The patient subsequently underwent intravenous immunoglobulin (IVIG) treatment for five days which resulted in significant improvement in her bilateral lower extremity weakness, a response consistent with the diagnosis of GBS.