Abstract
Background
Malaria is an infectious disease caused by Plasmodium parasites, transmitted to humans by infected female Anopheles mosquitoes. Five Plasmodium species infect humans: P. vivax, P. falciparum, P. ovale, P. malariae, and P. knowlesi. Guillain-Barré Syndrome (GBS) is an inflammatory condition leading to paralysis, muscle weakness, autonomic dysfunction, respiratory failure, and sensory symptoms. GBS typically follows an infection with Campylobacter bacteria, commonly found in undercooked poultry, but is rarely associated with malaria.
Clinical presentation
A 16-year-old female presented with a 4-day history of progressive inability to move her lower extremities, accompanied by 8 days of persistent non-radiating back pain and fatigue. She also had fever and headache for 13 days and was treated with Quartum 4 tablets, taken twice daily for 3 days. Motor examination revealed a motor score of 1/5 in both lower extremities and 4/5 in upper extriemity, decreased muscle tone, and absent deep tendon reflexes (0/4). After completing treatment in the medical ward, she was discharged with improvement, showing motor examination power of 4/5 and reflexes of 1/4.
Discussion
Guillain-Barré Syndrome (GBS) is an acute paralytic illness often triggered by infections, particularly viral ones. It is the leading cause of sudden muscle weakness and paralysis, typically following respiratory or gastrointestinal infections, with Campylobacter jejuni being the most common cause. GBS progresses rapidly, with symptoms worsening over days to weeks and peaking within four weeks. It is characterized by progressive muscle weakness starting in the legs, spreading upwards, areflexia, and sensory symptoms like tingling or numbness in the feet and hands. Electrophysiological studies can confirm nerve involvement but are not always necessary if clinical and CSF findings strongly indicate GBS.
Conclusion.
In conclusion, while malaria is an exceptionally rare cause of Guillain-Barré Syndrome (GBS), it should be considered in patients with recent malaria infection who present with GBS symptoms.