Human immunodeficiency virus infection presenting as a fatal case of Guillain-Barré syndrome on a background of diabetes mellitus

Abstract

Background: Guillain-Barré syndrome (GBS), a post-infective acute polyneuropathy, which occurs rarely among Africans, has been associated with HIV infection and less commonly with diabetes mellitus. Aim: The article documents a case of GBS occurring on the setting of HIV infection on a background of diabetes mellitus. Findings: A 47 years old man presented with features of inability to walk, “pins and needles” sensation in the lower limbs, progressive lower limb weakness of 3 days duration and later on admission involving the upper limbs and, finally respiratory distress leading to his death on the 3rd day of hospital admission. He had an antecedent history of a diarrheal illness 3 weeks prior to his admission, and was treated at a private hospital without any complication. He was observed to have concomitant HIV infection and diabetes mellitus. He was not previously known to have any of these diseases and initially diagnosed as having acute diabetic neuropathy. Conclusion: GBS can occur in the setting of HIV infection on a background of DM and may be associated with a poor prognosis. There is a need to have a high index of suspicion in making a diagnosis of GBS in diabetic patients when it occurs concomitantly with HIV infection.

Key words: HIV, Guillain-Barré Syndrome, diabetes mellitus, paralysis, presenting, progressive weakness