title: Swiss national prospective surveillance of paediatric Mycoplasma pneumoniae-associated encephalitis.
abstract: OBJECTIVE
  To assess the presence of Mycoplasma pneumoniae-associated encephalitis in children in Switzerland and its likely pathogenesis.
  
  
  METHODS
  M. pneumoniae-associated encephalitis cases seen at a single-centre during 2010-2013 were reviewed, and the Swiss Paediatric Surveillance Unit (SPSU) prospectively conducted a nationwide surveillance 2013-2015. Case definition included confirmed, probable and possible cases.
  
  
  RESULTS
  Seven patients (median age 8.7 years, range 4.7-10.1 years) with confirmed or possible M. pneumoniae-associated encephalitis were observed. All patients manifested prodromal respiratory symptoms over at least 5 days and five out of the six who had a chest radiograph, showed pulmonary infiltrates. M. pneumoniae DNA in cerebrospinal fluid was negative in all patients. Intrathecally synthesised M. pneumoniae-specific immunoglobulin (IgM and IgG) were investigated and found positive in one patient (confirmed case). M. pneumoniae DNA in respiratory specimens and/or M. pneumoniae-specific IgM and IgG in serum were detected in the other six patients (possible cases). One confirmed and two possible cases had neurological sequelae at 4-19 months follow-up.
  
  
  CONCLUSIONS
  The lack of detectable M. pneumoniae DNA in cerebrospinal fluid of our encephalitis patients suggests a likely immune-mediated pathogenesis ignited by a respiratory inflammatory process including pneumonia.
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Switzerland; Children's Research Center (CRC); University Children's Hospital of Zurich, Switzerland.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Meyer Sauteur
authors.affiliation: Division of Respiratory Medicine, University Children's Hospital of Zurich, Switzerland; Children's Research Center (CRC); University Children's Hospital of Zurich, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Moeller
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Switzerland; Children's Research Center (CRC); University Children's Hospital of Zurich, Switzerland.
authors.forename: Christa
authors.initials: C
authors.lastname: Relly
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Switzerland; Children's Research Center (CRC); University Children's Hospital of Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Berger
authors.affiliation: Division of Neurology, University Children's Hospital of Zurich, Switzerland; Children's Research Center (CRC); University Children's Hospital of Zurich, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Plecko
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital of Zurich, Switzerland; Children's Research Center (CRC); University Children's Hospital of Zurich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Nadal
mesh_terms: D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000134:cerebrospinal fluid; D000069544:Infectious Encephalitis / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D009175:Mycoplasma Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D009177:Mycoplasma pneumoniae / Q000235:genetics / Q000276:immunology; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D011446:Prospective Studies; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M