Guillain–Barrè syndrome as a neurological complication of infective endocarditis. Is it really so rare and how often do we recognise it?

Abstract

Guillain–Barrè syndrome (GBS) is an acute, inflammatory, demyelinating polyneuropathy that nowadays represents the most common cause of flaccid paralysis. GBS is considered a reactive, autoimmune disease preceded by a triggering event, such as a respiratory infection or gastroenteritis. Campylobacter jejuni, Mycoplasma pneumoniae, Cytomegalovirus and Ebstein Barr Virus are the most frequent antecedent pathogens isolated in GBS; nevertheless recent reports suggest that pathogens related to infective endocarditis may be the triggers of this generalized polyneuropathy. We discuss the likely pathogenesis of this rare association and review the pertinent literature.