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Mycoplasma pneumoniae: Innocent Bystander or a True Cause of Central Nervous System Disease?

Ari Bitnun1, Susan E Richardson

  • 1Division of Infectious Diseases, Department of Paediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada, ari.bitnun@sickkids.ca.

Current Infectious Disease Reports
|February 11, 2011
PubMed

Insights

Mycoplasma pneumoniae is a cause of central nervous system (CNS) disease, potentially through direct infection. Diagnosis requires multiple tests and ruling out other causes due to assay limitations.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Microbiology

Background:

  • Mycoplasma pneumoniae is frequently linked to encephalitis.
  • Increased CNS disease incidence correlates with M. pneumoniae respiratory outbreaks.
  • Proposed mechanisms include direct infection, autoimmunity, and vascular occlusion.

Purpose of the Study:

  • To evaluate Mycoplasma pneumoniae as a central nervous system (CNS) pathogen.
  • To review evidence supporting direct CNS infection by M. pneumoniae.
  • To discuss diagnostic challenges and recommendations for M. pneumoniae-associated CNS disease.

Main Methods:

  • Review of existing evidence on M. pneumoniae and CNS disease.
  • Analysis of proposed pathophysiologic mechanisms.
  • Evaluation of diagnostic methods including serology and PCR.

Main Results:

  • Evidence supports M. pneumoniae's ability to directly infect the CNS.
  • Organism's DNA found in serum and CSF of affected individuals.
  • Animal studies demonstrate CNS invasion by Mycoplasma species.

Conclusions:

  • Mycoplasma pneumoniae plays a role as a CNS pathogen.
  • Diagnosis is challenging due to limitations in current assays.
  • A combination of positive tests and exclusion of other diagnoses is recommended.

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