title: Prognostic values of a combination of intervals between respiratory illness and onset of neurological symptoms and elevated serum IgM titers in Mycoplasma pneumoniae encephalopathy.
abstract: OBJECTIVE
  To retrospectively analyze the clinical manifestations of Mycoplasma pneumoniae (M. pneumoniae)-associated encephalopathy in pediatric patients.
  
  
  METHODS
  Pediatric patients with positive serum anti-M. pneumoniae immunoglobulin M (IgM) were enrolled in this study. Clinical signs and symptoms, laboratory data, neuroimaging findings, and electrophysiological data were reviewed.
  
  
  RESULTS
  Of 1000 patients identified, 11 (1.1%; male:female ratio = 7:4) had encephalopathy and were admitted to the pediatric intensive care unit. Clinical presentation included fever, symptoms of respiratory illness, and gastrointestinal upset. Neurological symptoms included altered consciousness, seizures, coma, focal neurological signs, and personality change. Neuroimaging and electroencephalographic findings were non-specific. Specimens of cerebrospinal fluid (CSF) for M. pneumoniae polymerase chain reaction (PCR) were negative. Higher M. pneumoniae IgM titers and longer intervals between respiratory and CNS manifestations were associated with worse outcomes.
  
  
  CONCLUSIONS
  Clinical manifestations of M. pneumoniae-associated encephalopathy were variable. Diagnosis of M. pneumoniae encephalopathy should not rely on CSF detection of M. pneumoniae by PCR. M. pneumoniae IgM titers and intervals between respiratory and CNS manifestations might be possibly related to the prognosis of patients with M. pneumoniae-associated encephalopathy.
authors: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Chih-Fen
authors: CF
authors: Hu
authors: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Chih-Chien
authors: CC
authors: Wang
authors: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Shyi-Jou
authors: SJ
authors: Chen
authors: Division of Clinical Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Cherng-Lih
authors: CL
authors: Perng
authors: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
authors: Hsin-Yi
authors: HY
authors: Yang
authors: Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: fanhuengchuen@yahoo.com.tw.
authors: Hueng-Chuen
authors: HC
authors: Fan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D015278:Intensive Care Units, Pediatric; D008297:Male; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000150:complications* / Q000473:pathology*; D011379:Prognosis; D065166:Sepsis-Associated Encephalopathy / Q000473:pathology*
chemical_list: D007075:Immunoglobulin M
keywords: Anti-M. pneumoniae immunoglobulin M (IgM); Cerebrospinal fluid (CSF); M. pneumoniae-associated encephalopathy; Mycoplasma pneumonia; Polymerase chain reaction (PCR)