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Mycoplasma pneumoniae causing nervous system lesion and SIADH in the absence of pneumonia

Miguel Coelho1, Alfredo Leite, Artur Revés

  • 1Intensive Care Unit, Hospital Dr. Fernando Fonseca, IC 19, 2720 Amadora, Portugal. migcoelho2002@yahoo.es

Clinical Neurology and Neurosurgery
|March 9, 2004
PubMed

Insights

Mycoplasma pneumoniae infection can cause severe neurological symptoms like paralysis and delirium, even without respiratory illness. Prompt antibiotic treatment led to rapid symptom recovery in this unique case.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Mycoplasma pneumoniae (MP) is a common cause of respiratory infections.
  • Neurological complications of MP infections are rare but can be severe.
  • This case presents a unique neurological presentation of MP infection.

Observation:

  • A patient presented with fever, acute respiratory failure, tetraparesis, delirium, behavioral changes, and diplopia.
  • Laboratory findings included leukocytosis, elevated C-reactive protein, and SIADH.
  • Cerebrospinal fluid analysis revealed mononuclear pleocytosis and elevated protein.
  • Electrodiagnostic studies showed demyelinating polyneuropathy and axonal degeneration.

Findings:

  • Serum IgG and IgM for MP confirmed acute infection.
  • The patient experienced rapid symptom resolution after starting erythromycin.
  • Notably, the patient lacked an associated respiratory disease, deviating from typical MP presentations.
  • SIADH associated with MP infection is exceptionally rare, with only one prior report, and that patient lacked direct CNS involvement.

Implications:

  • This case highlights the potential for MP to cause severe and diverse neurological manifestations.
  • It underscores the importance of considering MP in the differential diagnosis of unexplained neurological syndromes, even in the absence of respiratory symptoms.
  • The co-occurrence of SIADH and CNS involvement in MP infection warrants further investigation into pathogenic mechanisms.

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