A Case of Severe Encephalitis with Mycoplasma pneumoniae Infection in a 4-Year-Old Boy
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Mycoplasma pneumoniae (MP) infection can result in extrapulmonary and respiratory manifestations. The direct invasion by MP and the indirect invasion by immune-mediated response have been suggested as the pathogenesis of extrapulmonary manifestations. Neurologic manifestations are the most common among the extrapulmonary manifestations associated with MP infection. We report the case of a 4-year-old previously healthy boy with encephalitis accompanied by MP pneumonia. The patient’s respiratory manifestations appeared 14 days before the neurological manifestations. Leukocytosis was observed in the patient’s cerebrospinal fluid, but the result of the MP polymerase chain reaction was negative. The magnetic resonance imaging of the patient’s brain showed high signal intensity at bilateral basal ganglia. The chest radiograph confirmed the presence of lobar pneumonia. The serological test on MP-specific immunoglobulin M titer revealed a positive result. The clinical course improved with the administration of immunomodulatory therapies, but the patient subsequently developed spastic quadriplegic cerebral palsy. MP is a common pathogen in children and may induce aggravating neurologic diseases. Thus, MP should be considered a causative agent of encephalitis in children. Immunomodulatory drugs are the recommended therapeutic option for severe MP encephalitis.
Abstract
Mycoplasma pneumoniae (MP) infection can result in extrapulmonary and respiratory manifestations. The direct invasion by MP and the indirect invasion by immune-mediated response have been suggested as the pathogenesis of extrapulmonary manifestations. Neurologic manifestations are the most common among the extrapulmonary manifestations associated with MP infection. We report the case of a 4-year-old previously healthy boy with encephalitis accompanied by MP pneumonia. The patient’s respiratory manifestations appeared 14 days before the neurological manifestations. Leukocytosis was observed in the patient’s cerebrospinal fluid, but the result of the MP polymerase chain reaction was negative. The magnetic resonance imaging of the patient’s brain showed high signal intensity at bilateral basal ganglia. The chest radiograph confirmed the presence of lobar pneumonia. The serological test on MP-specific immunoglobulin M titer revealed a positive result. The clinical course improved with the administration of immunomodulatory therapies, but the patient subsequently developed spastic quadriplegic cerebral palsy. MP is a common pathogen in children and may induce aggravating neurologic diseases. Thus, MP should be considered a causative agent of encephalitis in children. Immunomodulatory drugs are the recommended therapeutic option for severe MP encephalitis.
참고문헌 (14)
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