Differential Diagnosis for Infectious Etiology of Bilateral Lower Extremity Weakness and Numbness
- Single Most Likely Diagnosis
- Guillain-Barré Syndrome: An autoimmune disorder often triggered by a recent infection, leading to rapid onset of muscle weakness and numbness, typically starting in the lower extremities and ascending. It is a common cause of bilateral lower extremity weakness and numbness with an infectious etiology.
- Other Likely Diagnoses
- Lyme Radiculopathy: Caused by Borrelia burgdorferi, the bacteria responsible for Lyme disease, leading to radicular pain, weakness, and numbness, which can present bilaterally in the lower extremities.
- West Nile Virus Neuropathy: West Nile virus infection can lead to neurological manifestations, including meningitis, encephalitis, and acute flaccid paralysis, which can cause bilateral lower extremity weakness and numbness.
- Syphilis (Tabes Dorsalis): A late manifestation of syphilis infection, characterized by degeneration of the dorsal columns and roots of the spinal cord, leading to symptoms like lightning pains, ataxia, and loss of reflexes, which can include bilateral lower extremity weakness and numbness.
- Do Not Miss Diagnoses
- Spinal Epidural Abscess: A serious infection that can compress the spinal cord, leading to rapid onset of neurological deficits, including bilateral lower extremity weakness and numbness. Early diagnosis and treatment are crucial to prevent permanent damage.
- Transverse Myelitis: An inflammation of the spinal cord that can be caused by infections, leading to bilateral sensory, motor, and autonomic dysfunction. It is a medical emergency requiring prompt diagnosis and treatment.
- Rare Diagnoses
- Poliomyelitis: Although largely eradicated in many parts of the world, polio can still cause acute flaccid paralysis, including bilateral lower extremity weakness and numbness, especially in areas with low vaccination rates.
- Diphtheria: A bacterial infection that can lead to neurological manifestations, including neuropathy, which might present as bilateral lower extremity weakness and numbness, particularly if the infection is not promptly treated.
- Leptospirosis: A zoonotic infection that can cause a wide range of symptoms, including neurological manifestations like meningitis and neuropathy, potentially leading to bilateral lower extremity weakness and numbness.