CENTRAL NERVOUS SYSTEM DISEASE ASSOCIATED WITH MYCOPLASMA PNEUMONIAE INFECTION:

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Abstract
CNS disease associated with Mycoplasma pneumoniae infection is being recognized with increasing frequency. This report documents the occurrence of encephalitis and/or polyradiculitis in five children who had M. pneumoniae infections diagnosed on the basis of fourfold or greater changes in complement fixation titers to M. pneumoniae. A review of 50 reported cases indicates that cerebrum, cerebellum, spinal cord, and nerve roots can be affected singly or in combination. More than half of the patients have been under 21 years of age, and there is a striking male preponderence in this younger age group. Fifty-eight percent of patients had antecedent bronchitis and/or pneumonia, and 21% had antecedent URI; 21% had no antecedent respiratory symptoms. Patients under 14 years of age, patients with encephalitis or polyradiculitis, and patients with higher CSF cell count and protein concentration seemed to have a worse prognosis for full neurological recovery. The pathogenesis of this complication of M. pneumoniae infection is unclear. Therapy is supportive; tetracycline and corticosteroids have been used in the past, but a clearly beneficial effect has not been shown. In patients with aseptic meningitis, encephalitis, acute cerebellar ataxia, and polyradiculitis, diagnostic laboratory studies should include cultures and serologic tests for M. pneumoniae.

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