Central Nervous System Manifestations Associated with Serologically Verified Mycoplasma Pneumoniae Infection

Abstract

Among 560 hospitalized patients with serologically verified Mycoplasma pneumoniae infection (significant titre rise of complement-fixing antibodies in paired sera), 27 (4.8%) had central nervous system (CNS) manifestations for which no evidence incriminating any other causal agent could be found. Of these patients 18 had encephalitis or meningoencephalitis, 8 aseptic meningitis and 1 polyradiculitis. Of the patients with meningoencephalitis 4 died and 3 had permanent sequelae. The cases of aseptic meningitis were benign without any deaths or sequelae. There was a predominance of young age groups, 13 patients (48%) being below 10 years of age. Neither erythromycin nor tetracycline had a beneficial effect on the course of the illness in a few patients treated. Another 15 patients had CNS manifestations for which an alternative aetiology was suspected. The specificity of the M. pneumoniae CF test in the diagnostics of CNS manifestations is discussed, as well as the pathogenesis of the CNS complications associated with M. pneumoniae infection. Some features are summarized from 87 case reports presented earlier in the literature.