Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

Abstract

Objective In this retrospective study, we aimed to assess frequency, types, and long-term outcome of neurological disease during acute Mycoplasma pneumoniae (M. pneumoniae) infection in pediatric patients. Materials and Methods Medical records of patients hospitalized with acute M. pneumoniae infection were reviewed. Possible risk factors were analyzed by uni- and multivariate regression. Patients with neurological symptoms were followed up by expanded disability status score (EDSS) and the cognitive problems in children and adolescents (KOPKJ) scale. Results Out of 89 patients, 22 suffered from neurological symptoms and signs. Neurological disorders were diagnosed in 11 patients: (meningo-) encephalitis (n = 6), aseptic meningitis (n = 3), transverse myelitis (n = 1), and vestibular neuritis (n = 1), 11 patients had nonspecific neurological symptoms and signs. Multivariate logistic regression identified lower respiratory tract symptoms as a negative predictor (odds ratio [OR] = 0.1, p < 0.001), a preexisting immune deficit was associated with a trend for a decreased risk (OR = 0.12, p = 0.058). Long-term follow-up after a median of 5.1 years (range, 0.6-13 years) showed ongoing neurological deficits in the EDSS in 8/18, and in the KOPKJ in 7/17. Conclusion Neurological symptoms occurred in 25% of hospitalized pediatric patients with M. pneumoniae infection. Outcome was often favorable, but significant sequels were reported by 45%.

Mycoplasma pneumoniae from the Respiratory Tract and Beyond

“…Involvement can occur in the brain, spinal cord, meninges, and peripheral nerves. The primary brain manifestation is encephalitis, which occurs more commonly in children than in adults and may not have a respiratory component to the illness (180,(238)(239)(240)(241)(242)(243). M. pneumoniae may be responsible for as many as 13% of encephalitis cases (244).…”

Mycoplasma pneumoniae: A Potentially Severe Infection

“…Poor correlations between serology and PCR assessments for MP infections in patients with neurological manifestations make the diagnosis difficult, especially because it prevents identification of the convalescent phase [ 5 ]. A long-term follow-up study of children with MP infections reported cases of significant neurological disability [ 51 ].…”

Real‐Time PCR and Quantitative Culture for Mycoplasma pneumoniae Load in Pharyngeal Swabs from Children at Preliminary Diagnosis and Discharge

“…Although M. pneumoniae pneumonia (MPP) is usually considered a self-limited disease, it may trigger pulmonary complications that may progress into refractory M. pneumoniae pneumonia (RMPP), severe M. pneumoniae pneumonia (SMPP), and even lethal pneumonia [9,10]. Meanwhile, some may present concurrent infection and multiple-organ infection, which results in poor prognosis [11,12]. erefore, M. pneumoniae infection is a heavy burden to the pediatric practice worldwide.…”