# A case of Guillain-Barré syndrome due to infection with Rickettsia conorii in Tunisia

**Authors:** Yosr BEN TAHER, Rania AMMAR, Mabrouk BAHLOUL, Chokri BEN HAMIDA

PMC · DOI: 10.48327/mtsi.v5i4.2025.768 · Médecine Tropicale et Santé Internationale · 2025-10-22

## TL;DR

A 29-year-old Tunisian patient developed Guillain-Barré syndrome linked to Rickettsia conorii infection, highlighting the need for awareness in endemic regions.

## Contribution

Reports a rare case linking Rickettsia conorii infection to Guillain-Barré syndrome in Tunisia.

## Key findings

- A 29-year-old patient presented with respiratory distress and flaccid quadriplegia due to Guillain-Barré syndrome.
- Rickettsia conorii infection was confirmed via serology and linked to the neurological condition.
- Treatment with immunoglobulins and doxycycline led to clinical improvement.

## Abstract

La fièvre boutonneuse méditerranéenne, causée par Rickettsia conorii, est une infection endémique dans le bassin méditerranéen, transmise principalement par les tiques. L’association entre cette infection et le syndrome de Guillain-Barré (SGB) est rare.

Nous rapportons le cas d’un patient tunisien de 29 ans, sans antécédents médicaux, présentant une quadriplégie flasque évoluant vers une détresse respiratoire, associée à une fièvre persistante et une hépatosplénomégalie. Le diagnostic de SGB sous sa forme axonale motrice aiguë, a été confirmé par électroneuromyogramme et l’infection à R. conorii par la sérologie. Le traitement par immunoglobulines et doxycycline a conduit à une amélioration clinique progressive.

Ce cas souligne l’importance de penser à l’infection à R. conorii, devant un SGB associé à des signes systémiques en particulier dans un pays endémique comme la Tunisie.

## Linked entities

- **Chemicals:** doxycycline (PubChem CID 54671203)
- **Diseases:** Guillain-Barré syndrome (MONDO:0016218)

## Full-text entities

- **Genes:** CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}
- **Diseases:** MA (OMIM:157300), FBM (MESH:D001907), Bacterial infections (MESH:D001424), d'eruption cutanee (MESH:C538319), hypochromic microcytic regenerative anemia (MESH:C536357), facial paralysis (MESH:D005158), swallowing disorders (MESH:D003680), pressure sores (MESH:D003668), inflammatory anemia (MESH:D000740), neurological damage (MESH:D020196), Immune (MESH:D007154), de R. typhi (MESH:C580424), viral hepatitis B and C (MESH:D006525), Infection (MESH:D007239), encephalitis (MESH:D004660), eruption (MESH:D003875), lesion (MESH:D009059), IFI (MESH:D051556), maculopapular rash (MESH:D005076), pneumopathie (MESH:C535590), seroconversion (MESH:D006679), stroke (MESH:D020521), pneumonia (MESH:D011014), eruptive fever (MESH:D005334), paraplegia (MESH:D010264), respiratory distress (MESH:D012128), acute disseminated encephalomyelitis (MESH:D004673), loss of deep tendon reflexes (MESH:D012021), flaccid quadriplegia (MESH:D011782), inflammatory (MESH:D007249), basal interstitial syndrome (MESH:D007984), skin lesions (MESH:D012871), vision loss (MESH:D014786), GBS (MESH:D020275), Rickettsial infections (MESH:D012282), polyradiculoneuritis (MESH:D011129), hepatosplenomegalie (MESH:C535727), meningitis (MESH:D008580)
- **Chemicals:** IgG (-), iron (MESH:D007501), doxycycline (MESH:D004318)
- **Species:** Rhipicephalus sanguineus (brown dog tick, species) [taxon 34632], Coxiella (genus) [taxon 1260513], Bartonella (genus) [taxon 773], West Nile virus (no rank) [taxon 11082], Rickettsia typhi (species) [taxon 785], Rickettsia conorii (species) [taxon 781], Homo sapiens (human, species) [taxon 9606], Rickettsia felis (species) [taxon 42862], Mycoplasma (genus) [taxon 2093], Ovis aries (domestic sheep, species) [taxon 9940], Human immunodeficiency virus 1 (no rank) [taxon 11676], Legionella (genus) [taxon 445], Canis lupus familiaris (dog, subspecies) [taxon 9615]

## Full text

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## References

16 references — full list in the complete paper: https://tomesphere.com/paper/PMC12948365/full.md

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Source: https://tomesphere.com/paper/PMC12948365