title: Complete occlusion of the right middle cerebral artery associated with Mycoplasma pneumoniae pneumonia.
abstract: We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed complete occlusion of the right middle cerebral artery. Mycoplasma pneumoniae infection was identified by a 4-fold increase in IgG antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. Fibrinogen and D-dimer levels were elevated, while laboratory exams in order to identify other predisposing factors of pediatric stroke were all negative. This is the first reported pediatric case in English literature of a M. pneumoniae-associated cerebral infarction involving complete occlusion of the right middle cerebral artery.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ben
authors.initials: B
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Byong Kwan
authors.initials: BK
authors.lastname: Son
authors.affiliation: Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Myung Kwan
authors.initials: MK
authors.lastname: Lim
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yon Ho
authors.initials: YH
authors.lastname: Choe
authors.affiliation: Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Young Se
authors.initials: YS
authors.lastname: Kwon
keywords: Cerebral infarction; Middle cerebral artery infarction; Mycoplasma pneumoniae