Mycoplasma meningitis resulting in increased production of cerebrospinal fluid: case report and review of the literature.
OBJECTIVE
We report a case of increased cerebrospinal fluid (CSF) production in a child with concomitant mycoplasma meningitis.


METHODS
This 4-year-old boy presented with a 2-week history of body aches, malaise, and headaches. He developed sudden onset of obtundation, apnea, left eye deviation, and bilateral dilated and unreactive pupils. A ventriculostomy was placed initially for a poor neurologic examination in the setting of likely meningitis. Initial intracranial pressure was high, and CSF production was supraphysiologic for the first few days of empiric, broad-spectrum treatment. Mycoplasma meningitis was diagnosed. The ventriculostomy was weaned after adequate treatment for mycoplasma meningitis.


CONCLUSIONS
At 4 months follow-up, the child remains shunt-free with only mild cognitive-linguistic impairment. Untreated mycoplasma meningitis may cause raised intracranial pressure (possibly as a result of increased CSF production) and result in a poor neurological examination. In this setting, CSF diversion in the form of an external ventricular drain may be beneficial to preserve neurologic function during treatment with antibiotics.
Bauer
David F
DF
Division of Neurosurgery, University of Alabama, Birmingham, AL, USA.
Tubbs
R Shane
RS
Acakpo-Satchivi
Leslie
L
D015170:Cerebrospinal Fluid Pressure / Q000502:physiology*; D002675:Child, Preschool; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000473:pathology / Q000601:surgery; D009175:Mycoplasma Infections / Q000150:complications* / Q000473:pathology; D014696:Ventriculostomy / Q000379:methods