Bulbar-predominant myasthenia gravis masquerading as pneumonia and sepsis in a young adult: a case from a low-resource setting

Abstract

Myasthenia gravis (MG) usually presents with fluctuating ocular or limb weakness; bulbar-respiratory–predominant disease is less common and easily misattributed to infection or gastrointestinal pathology. We report a 24-year-old man whose year-long dysphagia and intermittent breathlessness culminated in presumed severe pneumonia and septic shock but was ultimately diagnosed as generalized MG—highlighting the value of clinical judgement and evidence-based case-finding when advanced tests are limited.