Campylobacter coli infection causes spinal epidural abscess with Guillain-Barré syndrome: a case report

Triple Co-infection With Salmonella typhi, Leptospira, and Campylobacter coli in a Patient From Guayaquil, Ecuador: Clinical and Diagnostic Challenges

This case report describes the unusual presentation of a 32-year-old male from Guayaquil, Ecuador, who was diagnosed with a rare triple infection caused by Salmonella typhi, Leptospira, and Campylobacter coli. The patient presented with persistent high fever, severe gastrointestinal symptoms, abdominal pain, and jaundice, following the consumption of street food in a resource-limited area. Important clinical findings included hepatosplenomegaly and elevated liver enzymes, which initially complicated the differential diagnosis. Laboratory tests confirmed the presence of all three pathogens, presenting significant diagnostic and therapeutic challenges due to overlapping symptoms and potential antimicrobial resistance (AMR). The main diagnoses included typhoid fever, leptospirosis, and campylobacteriosis, each requiring distinct yet coordinated treatment approaches. The patient was managed with a combination of antibiotics targeting each pathogen and supportive care to address dehydration and liver dysfunction. After a prolonged hospital stay, the patient recovered with no residual symptoms, underscoring the success of a tailored, multidisciplinary approach in the context of limited healthcare resources. This case underscores the importance of clinical awareness regarding co-infections, particularly in areas with inadequate sanitation, where infectious diseases are endemic. The successful management of this complex case highlights the necessity of rapid, accurate diagnostics and coordinated therapeutic strategies to improve outcomes in patients with multi-pathogen infections. This report also emphasizes the critical need for surveillance and tailored interventions in regions facing rising AMR, enhancing our understanding of how to approach emerging infectious diseases in underserved populations.

Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review

Background  Spinal epidural abscess is a rare but serious condition that can cause spinal cord compression and neurological deficits. Case Description and Methods  The article reports a case of a 31-year-old patient who presented with an infectious cellulitis in the left hand, which progressed to a spinal epidural abscess. The diagnosis was confirmed by clinical examination and magnetic resonance imaging. Treatment involved laminectomy, after which the patient had complete recovery of neurological deficits. This article is a case report with a literature review. Patient data and images were collected by the researchers who participated in the patient's care. The literature was reviewed by one of the researchers based on the search for articles in the PubMed database. For the research, the following keywords were inserted: "Spinal epidural empyema," "Spinal epidural abscess." Conclusion  Spinal epidural abscess is often underdiagnosed, which can lead to delays in treatment and serious complications. The relationship between cellulitis and spinal epidural abscess may be related to the spread of infection through the lymphatic or blood system.

Triggers of Guillain-Barré Syndrome: Campylobacter jejuni Predominates

Guillain-Barré syndrome (GBS) is a rare immune-mediated acute polyradiculo-neuropathy that typically develops after a previous gastrointestinal or respiratory infection. This narrative overview aims to summarise and discuss current knowledge and previous evidence regarding triggers and pathophysiology of GBS. A systematic search of the literature was carried out using suitable search terms. The most common subtypes of GBS are acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). The most common triggers of GBS, in three quarters of cases, are previous infections. The most common infectious agents that cause GBS include Campylobacter jejuni (C. jejuni), Mycoplasma pneumoniae, and cytomegalovirus. C. jejuni is responsible for about a third of GBS cases. GBS due to C. jejuni is usually more severe than that due to other causes. Clinical presentation of GBS is highly dependent on the structure of pathogenic lipo-oligosaccharides (LOS) that trigger the innate immune system via Toll-like-receptor (TLR)-4 signalling. AIDP is due to demyelination, whereas in AMAN, structures of the axolemma are affected in the nodal or inter-nodal space. In conclusion, GBS is a neuro-immunological disorder caused by autoantibodies against components of the myelin sheath or axolemma. Molecular mimicry between surface structures of pathogens and components of myelin or the axon is one scenario that may explain the pathophysiology of GBS.