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Central nervous system manifestations associated with serologically verified Mycoplasma pneumoniae infection
Abstract:
Among 560 hospitalized patients with serologically verified Mycoplasma pneumoniae infection (significant titre rise of complement-fixing antibodies in paired sera), 27 (4.8%) had central nervous system (CNS) manifestations for which no evidence incriminating any other causal agent could be found. Of these patients 18 had encephalitis or meningoencephalitis, 8 aseptic meningitis and 1 polyradiculitis. Of the patients with meningoencephalitis 4 died and 3 had permanent sequelae. The cases of aseptic meningitis were benign without any deaths or sequelae. There was a predominance of young age groups, 13 patients (48%) being below 10 years of age. Neither erythromycin nor tetracycline had a beneficial effect on the course of the illness in a few patients treated. Another 15 patients had CNS manifestations for which an alternative aetiology was suspected. The specificity of the M. pneumoniae CF test in the diagnostics of CNS manifestations is discussed, as well as the pathogenesis of the CNS complications associated with M. pneumoniae infection. Some features are summarized from 87 case reports presented earlier in the literature.
Insights
Mycoplasma pneumoniae infections can cause central nervous system (CNS) complications, including encephalitis and meningitis, particularly in children. Antibiotic treatments showed limited efficacy in affected patients.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Mycoplasma pneumoniae is a common respiratory pathogen.
- Central nervous system (CNS) involvement is a rare but serious complication of M. pneumoniae infection.
- Understanding the spectrum and outcomes of CNS manifestations is crucial for patient management.
Purpose of the Study:
- To investigate the incidence and characteristics of CNS manifestations in hospitalized patients with M. pneumoniae infection.
- To analyze the clinical presentation, outcomes, and potential treatments for these neurological complications.
- To discuss the diagnostic specificity and pathogenesis of M. pneumoniae-associated CNS disease.
Main Methods:
- Serological verification of Mycoplasma pneumoniae infection using complement-fixing antibodies.
- Retrospective analysis of hospitalized patients with confirmed M. pneumoniae infection.
- Classification of CNS manifestations including encephalitis, meningoencephalitis, aseptic meningitis, and polyradiculitis.
Main Results:
- Central nervous system (CNS) manifestations were observed in 4.8% (27/560) of hospitalized patients with M. pneumoniae infection.
- Encephalitis/meningoencephalitis occurred in 18 patients, with a mortality rate of 22% (4/18) and permanent sequelae in 17% (3/18).
- Aseptic meningitis cases (8 patients) were benign, with no deaths or sequelae; polyradiculitis occurred in 1 patient.
Conclusions:
- Mycoplasma pneumoniae can cause significant central nervous system (CNS) complications, notably encephalitis and meningoencephalitis, with considerable morbidity and mortality.
- Young children are disproportionately affected by these neurological manifestations.
- Current antibiotic therapies, including erythromycin and tetracycline, demonstrated limited benefit in treating M. pneumoniae-induced CNS disease.