Isolated optic neuritis associated with Mycoplasma pneumoniae infection: report of two cases and literature review.
Mycoplasma pneumonia is a major pathogen of primary atypical pneumonia and has been known to cause various kinds of extrapulmonary manifestations involving almost all organs of the human body. Optic neuritis associated with M. pneumoniae infection has rarely been described and mostly, it combined other neurological complications including meningitis, meningoencephalitis, myelitis, and peripheral neuropathy. We report two patients who presented with isolated optic neuritis due to M. pneumoniae infection, and reviewed the literatures on five additional patients. All patients are child or young adults, and optic neuritis was unilateral (n = 3) or bilateral (n = 4). Remarkably, four patients did not have preceding history of respiratory M. pneumonia infection, and ocular pain or headache was accompanied in only three. Although initial visual acuities were severely reduced in most cases, visual outcome was excellent after systemic steroid and/or antibiotics treatment. M. pneumonia infection should be considered in the differential diagnosis of isolated optic neuritis, especially when occurring in a child or young adults, even though there was no preceding pneumonia, accompanying ocular pain, or headache. Various mechanisms including direct local inflammation, vascular occlusion, or indirect immune modulation due to M. pneumonia infection can lead to isolated neurological manifestations without pneumonia.
Department of Neurology, College of Medicine, Pusan National University Hospital, Pusan National University, 179, Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
Seo-Young
SY
Choi
Department of Neurology, College of Medicine, Pusan National University Hospital, Pusan National University, 179, Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
You-Jin
YJ
Choi
Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Busan, Korea.
Jae-Hwan
JH
Choi
Department of Neurology, College of Medicine, Pusan National University Hospital, Pusan National University, 179, Gudeok-ro, Seo-gu, Busan, 602-739, Korea. kdchoi@pusan.ac.kr.
Kwang-Dong
KD
Choi
D002648:Child; D005260:Female; D006261:Headache / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D009177:Mycoplasma pneumoniae; D009902:Optic Neuritis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D011019:Pneumonia, Mycoplasma / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
Extrapulmonary manifestations; Mycoplasma pneumoniae; Optic neuritis