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Mycoplasma pneumoniae Associated Acute Transverse Myelitis: An Atypical Clinical Presentation in an Adolescent Child

Chong Bin He1, James R Lee2, Madelyn Kahana3

  • 1Pediatrics, University of Central Florida College of Medicine, Orlando, USA.

Cureus
|September 20, 2021
PubMed

Insights

This case highlights Mycoplasma pneumoniae-associated acute transverse myelitis (ATM) in a pediatric patient presenting without typical symptoms. Early detection is crucial to prevent severe neurological complications and improve outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Mycoplasma pneumoniae is a common pathogen, typically causing respiratory illness.
  • Acute transverse myelitis (ATM) is an inflammatory condition affecting the spinal cord.

Observation:

  • A 15-year-old presented with acute bilateral lower extremity paralysis, sensory deficits, and bowel/bladder dysfunction, diagnosed with ATM.
  • The patient lacked prodromal or pulmonary symptoms typically associated with Mycoplasma pneumoniae infection.
  • Spinal MRI confirmed transverse myelitis from T10 to the conus medullaris; thrombocytopenia was also noted.

Findings:

  • Despite treatment with azithromycin, methylprednisolone, IVIG, and plasmapheresis, the patient experienced slow clinical improvement.
  • This atypical presentation underscores the challenge in diagnosing Mycoplasma pneumoniae-associated ATM without classic symptoms.

Implications:

  • Early identification of Mycoplasma pneumoniae is critical for timely ATM diagnosis and treatment.
  • Delayed diagnosis and treatment can lead to severe neurologic complications, prolonged hospitalization, and poor clinical outcomes.
  • This case emphasizes the need for considering atypical infections in pediatric myelitis evaluations.
Keywords:
acute transverse myelitiscentral nervous system disorderimmune-mediated inflammatory disordermycoplasma pneumoniaeneurologic disorder

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