Guillain-Barré Syndrome Following Falciparum Malaria in an 18-Year Male Adolescent: A Rare Case Report and Literature Review.

Guillain-Barré Syndrome (GBS) is an immune-mediated disorder affecting the peripheral nerves and nerve roots, potentially leading to severe complications such as respiratory failure and autonomic dysfunction. It is commonly preceded by gastrointestinal or respiratory infections, with various bacterial and viral pathogens identified as potential triggers. However, GBS associated with parasitic infections, such as malaria, is a rare occurrence in the medical literature. We present the case of an 18-year-old male who developed progressive bilateral lower extremity weakness, eventually involving the upper extremities over 1 week. His symptoms were accompanied by voice changes, facial drooping, difficulty swallowing, and high-grade fever. On physical examination, he exhibited fluctuating vital signs and flaccid weakness with bulbar involvement. Cerebrospinal fluid (CSF) analysis revealed an elevated protein level of 172 mg/dL with no cells. Nerve conduction studies confirmed the acute motor and sensory axonal neuropathy (AMSAN) variant of GBS. A peripheral blood film was positive for the trophozoite stage of Plasmodium falciparum. The patient was managed with intravenous artesunate and supportive care. The weakness stabilized around day 14. He showed significant improvement in cranial nerve function and upper extremity strength at 1 month and was able to walk with minimal support at 2 months. This case report highlights the rare occurrence of GBS after Plasmodium falciparum infection, emphasizing the importance of early diagnosis to prevent serious complications. By adding to the limited existing literature, it aims to raise awareness and encourage further research on the condition and its management.