Diagnostic challenge and management of Guillain-Barre syndrome in an infant: a case report

<p><strong>Background:</strong> Guillain-Barre syndrome (GBS) is an acute, immune-mediated post-infectious polyradiculoneuropathy usually presenting with symmetrical ascending weakness, diminished deep tendon reflexes, and nonspecific sensory symptoms. GBS is, in essence, an autoimmune disorder, and the underlying mechanism is thought to result from so-called molecular mimicry. This hypothesis is further supported by approximately two-thirds of the patients having a preceding infection. In most cases, the infectious trigger occurs in the gastrointestinal or respiratory tract, with the disease manifesting within 4 weeks. Even though it most commonly affects children aged 1-5 years, there are rare cases reported in neonates and infants.<br /><strong>Case Presentation</strong>: We report a case of a 6-month-old infant with GBS following a respiratory infection. The diagnosis was confirmed through cerebrospinal fluid (CSF) analysis, electromyoneurography, spine MRI, and clinical assessment. Positive human herpes virus 6 (HHV-6) in CSF suggested a potential infectious trigger. The infant was treated with intravenous immunoglobulin and ganciclovir, requiring intensive care and mechanical ventilation. Recovery involved gradual neurological improvement and restored motor function over 30 days.<br /><strong>Conclusion:</strong> GBS is a rare disorder in children, especially when associated with HHV-6 infection. It requires multidisciplinary management to prevent complications and improve the prognosis of patients. Upon arrival at the emergency department, all patients should be carefully evaluated, looking for autonomic and respiratory dysfunction signs. Generally, pediatric patients have a better prognosis compared to adults. Initiation of treatment in the early stages of the disease leads to a faster recovery and, consequently, fewer sequelae.</p>