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Mycoplasma pneumoniae: nervous system complications in childhood and review of the literature

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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.

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References

  1. 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

    PubMed  CAS  Google Scholar 

  2. Biberfeld G (1971) Antibodies to brain and other tissues in cases of Mycoplasma pneumoniae infection. Clin Exp lmmunol 8:319–333

    CAS  Google Scholar 

  3. Biberfeld G, Norberg R (1974) Circulating immune complexes in Mycoplasma pneumoniae infection. J Immunol 112:413–415

    PubMed  CAS  Google Scholar 

  4. 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

    Article  PubMed  CAS  Google Scholar 

  5. Bitnun A, Ford-Jones E, Blaser S, Richardson S (2003) Mycoplasma pneumoniae encephalitis. Semin Pediatr Infect Dis 14:96–107

    Article  PubMed  Google Scholar 

  6. Daxboeck F (2006) Mycoplasma pneumoniae central nervous system infections. Curr Opin Neurol 19:374–378

    Article  PubMed  Google Scholar 

  7. Felice KJ, DiMario FJ, Conway SR (2005) Postinfectious myasthenia gravis: report of two children. J Child Neurol 20:441–444

    PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    PubMed  CAS  Google Scholar 

  10. Komatsu H, Kuroki S, Shimizu Y, Takada H, Takeuchi Y (1998) Mycoplasma pneumoniae meningoencephalitis and cerebellitis with antiganglioside antibodies. Pediatr Neurol 18:160–164

    Article  PubMed  CAS  Google Scholar 

  11. Korn IL, Abramsky O (1981) Myasthenia gravis following viral infection. Eur Neurol 20:435–439

    Article  PubMed  CAS  Google Scholar 

  12. 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

    PubMed  Google Scholar 

  13. Labro MT (1998) Anti-inflammatory activity of macrolides: a new therapeutic potential? J Antimicrob Chemother 41:37–46

    Article  PubMed  CAS  Google Scholar 

  14. Launes J, Paetau A, Linnavuori K, Iivanaineu M (1997) Direct invasion of the brain parenchyma by Mycoplasma pneumoniae. Acta Neurol Scand 95:374

    Article  PubMed  CAS  Google Scholar 

  15. MacFarlane PI, Miller V (1984) Transverse myelitis associated with Mycoplasma pneumoniae infection. Arch Dis Child 59:80–82

    PubMed  CAS  Google Scholar 

  16. 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

    Article  PubMed  CAS  Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. Narita M, Matsuzono Y, Togashi T, Kajii N (1992) DNA diagnosis of central nervous system infection by Mycoplasma pneumoniae. Pediatrics 90:250–253

    PubMed  CAS  Google Scholar 

  19. 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

    Article  PubMed  CAS  Google Scholar 

  20. Narita M, Tanaka H, Togashi T, Abe S (2005) Cytokines involved in CNS manifestations caused by Mycoplasma pneumoniae. Pediatr Neurol 33:105–109

    Article  PubMed  Google Scholar 

  21. Parker P, Puck J, Fernandez F (1981) Cerebral infarction associated with Mycoplasma pneumoniae. Pediatrics 67:373–375

    PubMed  CAS  Google Scholar 

  22. Pijpers E, van Rijswick RE, Takx-Köhlen B, Schrey G (1996) A clarithromycin-induced myasthenic syndrome. Clin Infect Dis 22:171–176

    Google Scholar 

  23. Pönkä A (1980) Central nervous system manifestations associated with serologically verified Mycoplasma pneumoniae infection. Scand J Infect Dis 12:175–184

    PubMed  Google Scholar 

  24. 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

    Article  PubMed  CAS  Google Scholar 

  25. 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

    Article  Google Scholar 

  26. Smith CI, Hammarström L, Berg JV (1978) Role of virus for the induction of myasthenia gravis. Eur Neurol 17:181–187

    Article  PubMed  CAS  Google Scholar 

  27. 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

    Article  PubMed  CAS  Google Scholar 

  28. 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

    Article  PubMed  CAS  Google Scholar 

  29. Thomas NH, Collins JE, Robb SA, Robinson RO (1993) Mycoplasma pneumoniae infection and neurological disease. Arch Dis Child 69:573–576

    PubMed  CAS  Google Scholar 

  30. 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

    Article  PubMed  CAS  Google Scholar 

  31. Tsiodras S, Kelesidis Th, Kelesidis I, Stamboulis E, Giamarellou H (2005) Central nervous system manifestations of Mycoplasma pneumoniae infections. J Infect 51:343–354

    Article  PubMed  CAS  Google Scholar 

  32. Tsiodras S, Kelesidis Th, Kelesidis I, Voumbourakis K, Giamarellou H (2006) Mycoplasma pneumoniae-associated myelitis: a comprehensive review. Eur J Neurol 13:112–124

    Article  PubMed  CAS  Google Scholar 

  33. 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

    Article  PubMed  Google Scholar 

  34. Wang CH, Chou ML, Huang CH (1998) Benign isolated abducens nerve palsy in Mycoplasma pneumoniae infection. Pediatr Neurol 18:71–72

    Article  PubMed  CAS  Google Scholar 

  35. 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

    PubMed  CAS  Google Scholar 

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Correspondence to Uluç Yiş.

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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

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  • DOI: https://doi.org/10.1007/s00431-008-0714-1

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