A Rare Case of Bilateral Optic Neuritis and Guillain-Barré Syndrome Post Mycoplasma pneumoniae Infection

ABSTRACT

Neurological complications are the most commonly encountered extra-pulmonary manifestation of infection with Mycoplasma pneumoniae (M. pneumoniae). Here the authors report the case of a 39-year-old woman who was admitted with acute-onset bilateral visual loss coinciding with ascending numbness. Clinical examination, neurological imaging, and nerve conduction studies revealed a syndrome of bilateral optic neuritis and Guillain-Barré syndrome (GBS). Serological testing confirmed recent exposure to M. pneumoniae. The patient did not experience any clinical benefit with pulsed intravenous methylprednisolone but demonstrated marked clinical and radiological improvement following 5 days of plasma exchange. This report will explore the diagnostic and therapeutic approach to patients with neuro-ophthalmological and neurological complications of M. pneumoniae infection in addition to discussing previously encountered cases.

KEYWORDS:

• Mycoplasma pneumoniae
• post-infectious inflammatory neuropathy
• post-infectious optic neuropathy
• plasma exchange
• optic neuritis
• Guillain-Barré syndrome

Acknowledgements

We would like to thank Najwa Bantan, Farrah Jabeen, Christina Dudau, and Tarek Yousry for their help with radiology interpretation, and Dr. C. Cordivari and Dr. D. Fialho for their help with neurophysiology. S.F.F. acknowledges support from the UCLH Biomedical Research Centre.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.