Abstract
Mycoplasma pneumoniae is an important pathogen which causes nervous system disorders during or after the course of a respiratory tract infection. The exact pathogenic mechanism which causes neurological disorders still remains unknown. Although meningoencephalitis and acute disseminated encephalomyelitis are common complications, there are few cases of acute transverse myelitis and isolated abducens nerve palsy associated with M. pneumoniae infection in childhood. The association between ocular myasthenia gravis and M. pneumoniae infection has not been described before. Here, we describe five patients with different nervous system complications associated with M. pneumoniae infection and discuss the pathological features of central nervous system involvement.
Similar content being viewed by others
References
Abramovitz P, Schvartzman P, Harel D, Lis I, Naot Y (1987) Direct invasion of the central nervous system by Mycoplasma pneumoniae: a report of two cases. J Infect Dis 155:482–487
Biberfeld G (1971) Antibodies to brain and other tissues in cases of Mycoplasma pneumoniae infection. Clin Exp lmmunol 8:319–333
Biberfeld G, Norberg R (1974) Circulating immune complexes in Mycoplasma pneumoniae infection. J Immunol 112:413–415
Bitnun A, Ford-Jones EL, Petric M, MacGregor D, Heurter H, Nelson S, Johnson G, Richardson S (2001) Acute childhood encephalitis and Mycoplasma pneumoniae. Clin Infect Dis 32:1674–1684
Bitnun A, Ford-Jones E, Blaser S, Richardson S (2003) Mycoplasma pneumoniae encephalitis. Semin Pediatr Infect Dis 14:96–107
Daxboeck F (2006) Mycoplasma pneumoniae central nervous system infections. Curr Opin Neurol 19:374–378
Felice KJ, DiMario FJ, Conway SR (2005) Postinfectious myasthenia gravis: report of two children. J Child Neurol 20:441–444
Guleria R, Nisar N, Chawla TC, Biswas NR (2005) Mycoplasma pneumoniae and central nervous system complications: a review. J Lab Clin Med 146:55–63
Kasahara I, Otsubo Y, Yanase T, Oshima H, Ichimaru H, Nakamura M (1985) Isolation and characterization of Mycoplasma pneumoniae from cerebrospinal fluid of a patient with pneumonia and meningoencephalitis. J Infect Dis 152:823–825
Komatsu H, Kuroki S, Shimizu Y, Takada H, Takeuchi Y (1998) Mycoplasma pneumoniae meningoencephalitis and cerebellitis with antiganglioside antibodies. Pediatr Neurol 18:160–164
Korn IL, Abramsky O (1981) Myasthenia gravis following viral infection. Eur Neurol 20:435–439
Koskiniemi M (1993) CNS manifestations associated with Mycoplasma pneumoniae infections: summary of cases at the University of Helsinki and review. Clin Infect Dis 17:S52–S57
Labro MT (1998) Anti-inflammatory activity of macrolides: a new therapeutic potential? J Antimicrob Chemother 41:37–46
Launes J, Paetau A, Linnavuori K, Iivanaineu M (1997) Direct invasion of the brain parenchyma by Mycoplasma pneumoniae. Acta Neurol Scand 95:374
MacFarlane PI, Miller V (1984) Transverse myelitis associated with Mycoplasma pneumoniae infection. Arch Dis Child 59:80–82
Maniu CV, Hellinger WC, Chu SY, Palmer R, Alvarez-Elcoro S (2001) Failure of treatment for chronic Mycobacterium abscessus meningitis despite adequate clarithromycin levels in cerebrospinal fluid. Clin Infect Dis 33:745–748
Mills RW, Schoolfield L (1992) Acute transverse myelitis associated with Mycoplasma pneumoniae infection: a case report and review of the literature. Pediatr Infect Dis J 11:228–231
Narita M, Matsuzono Y, Togashi T, Kajii N (1992) DNA diagnosis of central nervous system infection by Mycoplasma pneumoniae. Pediatrics 90:250–253
Narita M, Itakura O, Matsuzono Y, Togashi T (1995) Analysis of mycoplasmal central nervous system involvement by polymerase chain reaction. Pediatr Infect Dis J 14:236–237
Narita M, Tanaka H, Togashi T, Abe S (2005) Cytokines involved in CNS manifestations caused by Mycoplasma pneumoniae. Pediatr Neurol 33:105–109
Parker P, Puck J, Fernandez F (1981) Cerebral infarction associated with Mycoplasma pneumoniae. Pediatrics 67:373–375
Pijpers E, van Rijswick RE, Takx-Köhlen B, Schrey G (1996) A clarithromycin-induced myasthenic syndrome. Clin Infect Dis 22:171–176
Pönkä A (1980) Central nervous system manifestations associated with serologically verified Mycoplasma pneumoniae infection. Scand J Infect Dis 12:175–184
Riedel K, Kempf VAJ, Bechtold A, Klimmer M (2001) Acute disseminated encephalomyelitis (ADEM) due to Mycoplasma pneumoniae infection in an adolescent. Infection 29:240–242
Socan M, Ravnik I, Bencina D, Dovc P, Zakotnik B, Jazbec J (2001) Neurological symptoms in patients whose cerebrospinal fluid is culture- and/or polymerase chain reaction-positive for Mycoplasma pneumoniae. Clin Infect Dis 32:31–35
Smith CI, Hammarström L, Berg JV (1978) Role of virus for the induction of myasthenia gravis. Eur Neurol 17:181–187
Thomas L, Aleu F, Bitensky NW, Davidson M, Gesner B (1966) Studies of PPLO infection. II. The neurotoxin of Mycoplasma neurolyticum. J Exp Med 124:1067–1082
Thomas L, Davidson M, McCluskey RT (1966) Studies of PPLO infection. I. The production of cerebral polyarteritis by Mycoplasma gallisepticum in turkeys; the neurotoxic property of the mycoplasma. J Exp Med 123:897–912
Thomas NH, Collins JE, Robb SA, Robinson RO (1993) Mycoplasma pneumoniae infection and neurological disease. Arch Dis Child 69:573–576
Tjhie JHT, van de Putte EM, Haasnoot K, van den Brule AJC, Vandenbroucke-Grauls CMJE (1997) Fatal encephalitis caused by Mycoplasma pneumoniae in a 9-year-old girl. Scand J Infect Dis 29:424–425
Tsiodras S, Kelesidis Th, Kelesidis I, Stamboulis E, Giamarellou H (2005) Central nervous system manifestations of Mycoplasma pneumoniae infections. J Infect 51:343–354
Tsiodras S, Kelesidis Th, Kelesidis I, Voumbourakis K, Giamarellou H (2006) Mycoplasma pneumoniae-associated myelitis: a comprehensive review. Eur J Neurol 13:112–124
Unal O, Teber S, Kendirli T, Deda G, Anlar B (2007) Juvenile form of myasthenia gravis presenting as recurrent pulmonary infection with atelectasis. Pediatr Int 49:1007–1008
Wang CH, Chou ML, Huang CH (1998) Benign isolated abducens nerve palsy in Mycoplasma pneumoniae infection. Pediatr Neurol 18:71–72
Yamashita S, Ueno K, Hashimoto Y, Teramoto H, Uchino M (1999) A case of acute disseminated encephalomyelitis accompanying Mycoplasma pneumoniae infection. No To Shinkei 51:799–803
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yiş, U., Kurul, S.H., Çakmakçı, H. et al. Mycoplasma pneumoniae: nervous system complications in childhood and review of the literature. Eur J Pediatr 167, 973–978 (2008). https://doi.org/10.1007/s00431-008-0714-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-008-0714-1