Encefalomielitis aguda diseminada por Mycoplasma pneumoniae en un niño previamente sano

Abstract

We present here the case of a previously healthy 5 year-old boy hospitalized in an intensive care unit due to tonic-clonic seizures focused on the face and right side of the body, and axillary temperature of 37.4°C. Common bacterial and viral etiology was ruled out through studies of cerebrospinal fluid (CSF) samples. Mycoplasma pneumoniae was suspected by a positive immunofluorescence serum test for IgM class antibodies. Finally, with a brain biopsy, M. pneumoniae was confirmed by polymerase chain reaction (PCR) and acute disseminated encephalomyelitis by pathological anatomy. The patient was treated with clarithromycin and had an uneventful evolution. At least to our knowledge, this is the first case in which M. pneumoniae DNA was detected by PCR in a brain biopsy.

Neurological Complications of Mycoplasma pneumoniae Infection in Children

“…Since DNA cannot be detected with M. pneumoniae PCR in the CSF and respiratory tract in many patients and there is a certain amount of time between respiratory tract symptoms and neurologic symptoms, autoimmune mechanism is blamed in pathogenesis (13). However, the fact that M. pneumoniae DNA has been confirmed in the CSF of a patient diagnosed with M. pneumoniae-associated ADEM and that M. pneumoniae DNA has been determined in the brain biopsy material of a five-year-old child diagnosed with ADEM show that its pathogenesis has not still been fully explained (14,15). Indirect mechanism can explain the fact that ADEM-diagnosed Case 7 had respiratory tract symptoms 7 days prior and M. pneumoniae infection diagnosis was serologically made.…”