Cunha, et al. (2002). [Infection due to Mycoplasma pneumoniae: three cases with neurological complications]

[Wise Young]

• Cunha J, Madalena C, Guimaraes P, Sousa A and Temudo T (2002). [Infection due to Mycoplasma pneumoniae: three cases with neurological complications]. Rev Neurol 34:1053-6. Summary: INTRODUCTION: Mycoplasma pneumoniae infection has been associated with severe central nervous system diseases. The pathogenesis of these disorders is unknown and the treatment uncertain. CASE REPORTS: The authors present three cases of central nervous system diseases: acute transverse myelitis, cerebellitis and encephalomyelitis associated with M. pneumoniae infection. CONCLUSIONS: M. pneumoniae infection should be considered in all cases of severe acute central nervous system symptomatology. Servico de Pediatria, Hospital Geral de Santo Antonio, Porto, 4050, Portugal.

[Wise Young]

• Parisi A and Filice G (2001). Transverse myelitis associated with Mycoplasma pneumoniae pneumonitis: a report of two cases. Infez Med 9:39-42. Summary: The authors report two cases of transverse myelitis due to Mycoplasma pneumoniae occurring during a recent acute infection due to Epstein-Barr virus (EBV). The clinical picture included weakness of the legs, bladder dysfunction, fever, headache and in one case, a mild confusional state. Magnetic Resonance Imaging (MRI) revealed a segmental edema of the lumbar tract and cerebro-spinal fluid analysis showed a mild pleocytosis and an increased level of proteins with a blood-brain barrier damage. The diagnosis of acute infection due to Mycoplasma pneumoniae was made on serological criteria. The patients recovered completely after a 14-day course of an associated regimen with Ciprofloxacin (400 mg/day i.v.) plus prednisone (60 mg/day i.v.). The authors emphasise the immunological disorders in the combined infection with Mycoplasma pneumoniae and EBV, supposing that an infective mononucleosis may predispose to mycoplasmic transverse myelitis. Department of Infectious and Tropical Diseases, University of Pavia, IRCCS Policlinico San Matteo, Italy.

[Wise Young]

• Bjorn AM and Lebech AM (2002). [Extrapulmonary complications of Mycoplasma pneumoniae infections]. Ugeskr Laeger 164:1805-9. Summary: INTRODUCTION: Mycoplasma pneumoniae is a common cause of atypical pneumonia in children and young adults. The infection is generally mild and only a very few patients are admitted to hospital. However, extrapulmonary complications are well recognised--mostly as manifestations from the central nervous system (CNS). MATERIAL AND METHODS: We describe 21 patients with M. pneumoniae infection seen at Rigshospitalet, Copenhagen, from 1994 to 2000. RESULTS: The patients had fever, headache, myalgia, and cough. Biochemically, they were characterised by leucocytosis, an increased level of C-reactive protein, and infiltrations on the chest x-ray. A total of seven patients developed extrapulmonary complications to the infection in the form of encephalitis (3), polyradiculitis (1), transversel myelitis (1), erythema multiforme (3), cardial arrhythmia (1), and haemolytic anaemia (2). Three patients had more than one complication at the same time. DISCUSSION: The incidence of patients with complications to M. pneumoniae infection was higher than that reported in the literature, probably because these patients are typically submitted to the Department of Infectious Diseases, Rigshospitalet. The pathogenesis of extrapulmonary complications to M. pneumoniae infection is unknown. baybjoern@stofanet.dk