title: [Fulminant meningoencephalitis associated with Mycoplasma pneumoniae infection in adults. Aggressive treatment enabled a good outcome].
abstract: 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.
authors.affiliation: Neurologische Klinik, Universitätsklinikum der RWTH Aachen, Aachen. roland.sparing@post.rwth-aachen.de
authors.forename: Roland
authors.initials: R
authors.lastname: Sparing
authors.forename: Christoph
authors.initials: C
authors.lastname: Spitzer
authors.forename: Helga
authors.initials: H
authors.lastname: Häfner
authors.forename: Dirk
authors.initials: D
authors.lastname: Zolldann
authors.forename: Marcus H T
authors.initials: MH
authors.lastname: Reinges
authors.forename: Timo
authors.initials: T
authors.lastname: Krings
authors.forename: Johannes
authors.initials: J
authors.lastname: Noth
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Kosinski
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D007155:Immunologic Factors