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

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
• babesiosis
• enteritis
• Epstein-Barr viremia
• Guillain-Barre syndrome
• human monocytic ehrlichiosis
• tick-borne illness

Disclosure statement/Funding

The authors report no funding or conflicts of interests. Written consent to publish was obtained from the patient.