Neurological manifestations of Mycoplasma pneumoniae infection

Abstract

OBJECTIVE: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. Little is known about the extrapulmonary manifestations of this organism that are dominated by central nervous system (CNS) involvement. We aimed to identify the epidemiological and clinical peculiarities of M. pneumoniae infection with neurological manifestations and to analyze its therapeutic and evolutionary modalities. PATIENTS AND METHODS: Patients with neurological manifestations due to M. pneumoniae infection admitted in our department were scanned in the light of demographic, clinical, radiological features and response to treatment. RESULTS: Totally we conducted 15 patients with an average age 21.7±8 years. There were 8 men and 7 women. The average consultation time was 4±3 days. The most common symptoms were headache (73.3%), fever (60%), altered state of consciousness (20%) and focal signs (13.3%). Respiratory manifestations were associated in 7 cases (46.7%). The clinical entity was meningitis in 11 cases (73.3%), meningoencephalitis in 2 cases (13.3%), encephalitis and peripheral facial palsy in 1 case each (6.7%). All patients received probabilistic antibiotic therapy that was adapted after serology results. The molecules used were rovamycin in 5 cases (26.7%), doxycycline in 2 cases (13.3%) and chloramphenicol in 1 case (6.7%). The outcome was favorable without any sequelae in all cases. CONCLUSIONS: This study aims to prompt clinicians to consider extrapulmonary M. pneumoniae infection in the differential diagnosis for patients presenting with acute neurologic and respiratory symptoms.

Keywords

• mycoplasma pneumoniae
• meningitis
• meningoencephalitis
• macrolide.