[Fulminant meningoencephalitis associated with Mycoplasma pneumoniae infection in adults. Aggressive treatment enabled a good outcome].
Mycoplasma pneumoniae (M. pn.) commonly causes respiratory tract infections in humans. In a certain percentage of cases it may also be associated with various peripheral and central nervous system manifestations. We report a case of a 38-year-old previously healthy man who presented with hemiplegia and somnolence after he had suffered from a febrile respiratory infection 10 days earlier. Clinical features and laboratory investigations supported the diagnosis of an acute M. pneumoniae-associated meningoencephalitis. He was treated by an aggressive antibiotic and immunomodulatory regimen over the course of several weeks in the neurocritical care unit. Decompressive hemicraniectomy was performed due to life-threatening raised intracranial pressure. However, the patient recovered almost completely and presented with a mild neurological deficit after 3 months. Based on this case we give a review of the literature and discuss potential pathomechanisms and diagnostic approaches.
Sparing
Roland
R
Neurologische Klinik, Universitätsklinikum der RWTH Aachen, Aachen. roland.sparing@post.rwth-aachen.de
Spitzer
Christoph
C
Häfner
Helga
H
Zolldann
Dirk
D
Reinges
Marcus H T
MH
Krings
Timo
T
Noth
Johannes
J
Kosinski
Christoph M
CM
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D011019:Pneumonia, Mycoplasma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D020127:Recovery of Function; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007155:Immunologic Factors