Atypical Cause of Autoimmune Encephalitis: The Role of Mycoplasma pneumoniae in Status Epilepticus

Autoimmune encephalitis is a group of conditions characterized by a rapid onset of neurological symptoms, such as seizures and cognitive impairment, along with psychiatric disturbances such as behavioral changes and psychosis. Viral infections are common, well-documented triggers, but the role of bacterial pathogens, particularly Mycoplasma pneumoniae, remains poorly understood. Mycoplasma pneumoniae has been implicated in autoimmune encephalitis previously, but reported cases are rare. This report presents a case of Mycoplasma-induced seronegative autoimmune encephalitis in a previously healthy adult, highlighting the diagnostic challenges and the need for early recognition. The patient, a 37-year-old man with a past medical history of asthma, presented with encephalopathy and confusion following a fall in the shower a few hours previously. He then experienced refractory seizures necessitating intensive immunosuppressive and antimicrobial therapy. After a four-month hospital stay, primarily in the ICU, the patient returned to his baseline and was discharged home after four days without experiencing any new neurological deficits or seizures. Given the potential for delayed diagnosis and severe neurological complications, increased clinical awareness and further research are needed to improve diagnostic and therapeutic strategies for Mycoplasma-associated autoimmune encephalitis.