| Systemic infection caused by arcanobacterium haemolyticum is uncommon. We report a case of empyema and bacteraemia caused by this organism concomitant with mycoplasma pneumoniae infection. ( info) |
2/230. Anterior uveitis associated with mycoplasma pneumoniae pneumonia: a case report. The authors report a case of bilateral uveitis following mycoplasma pneumoniae pneumonia verified by IgM and rising IgG antibodies against the organism. uveitis is a rare manifestation of mycoplasma pneumoniae pneumonia and since it is a common pathogen, it should be considered in the differential diagnosis, even in the absence of respiratory symptoms or neurological findings. Immunobiological hypotheses are briefly discussed. ( info) |
3/230. Fulminant form of acute disseminated encephalomyelitis: successful treatment with hypothermia. We described herein a case of the fulminant form of acute disseminated encephalomyelitis (ADEM) that developed after mycoplasma pneumonia. A 28-year-old man who presented with fever, headache, and writing difficulty was admitted to our hospital in August 1997. He developed hernia on the 3rd hospital day. Surgical decompression and intravenous prednisolone failed to halt his progressive deterioration. We introduced systemic hypothermia and he has shown marked recovery; despite having Broca's type aphasia, he could comprehend spoken language and communicate with others by gesture. Head MRI demonstrated diffuse high signals over the white matter on fluid attenuated inversion recovery (FLAIR) images, which suggested extensive demyelination. The clinical course, imaging studies and presence of polymorphonuclear dominant leucocytosis in the blood and CSF in the patient are somewhat similar to findings in acute hemorrhagic leukoencephalitis, however, the result of a brain biopsy was inconclusive. The fulminant form of ADEM is usually fatal. Treatments such as corticosteroids, intravenous immunoglobulin, and surgical decompression have been performed to improve the prognosis. Our case results indicate that hypothermia, which suppresses both brain edema and immune response, may be included in the repertoire of treatment for the fulminant form of ADEM. ( info) |
4/230. Aplastic anemia after mycoplasma pneumoniae infection: a report of two cases. Two very unusual cases of aplastic anemia complicating mycoplasma infection are described. Each patient had preexisting hematologic abnormalities at the time of the infection: reactive hemophagocytic syndrome in one, and autoimmune hemolytic anemia associated with cold autoantibodies in the other. This adds another entity to the protean manifestations of mycoplasma pneumoniae infection. ( info) |
| A case of non-fatal encephalitis in a 21-y-old immunocompetent woman is described. High titre serum antibodies against mycoplasma pneumoniae were found. In addition, mycoplasma pneumoniae dna was detected in the cerebrospinal fluid by polymerase chain reaction. neuroimaging findings by magnetic resonance and computed tomographic scanning of the brain, and laboratory investigations, including a search for serum antibodies to gangliosides, did not support an immune-mediated mechanism. No other pathogens were found. These results strongly suggest that the encephalitis was caused directly by mycoplasma pneumoniae invasion of the central nervous system. They also indicate that such pathogenetic mechanism may sometimes be sufficient to explain neurological manifestations occurring during the course of mycoplasma pneumoniae infection. The consequences for therapy are discussed. ( info) |
| mycoplasma pneumoniae encephalitis is a recognized cause of reversible coma in children. As an etiology of infectious encephalitis, it yields a relatively poorer prognosis than most other causes of infectious encephalopathies. Encephalitis is generally diagnosed by a constellation of clinical symptoms and confirmed by a cerebrospinal fluid (CSF) examination revealing cell pleocytosis and elevated protein. That mycoplasma pneumoniae encephalopathy can occur in the presence of a normal CSF examination is less well appreciated. The authors report two children who presented with coma and normal CSF findings in whom a diagnosis of acute mycoplasma pneumoniae infection was made. The two children both had rapid and complete recovery over several days. These cases exemplify that coma can result from acute infection with mycoplasma pneumoniae in the absence of an inflammatory CSF response and that a normal CSF may herald a more favorable prognosis. ( info) |
| BACKGROUND. mycoplasma pneumoniae is responsible for approximately 20% of the cases of community-acquired pneumonia. The onset of respiratory symptoms is gradual and systemic complaints such as headache, malaise, arthalgias, and low-grade fever are frequently prominent. Extrapulmonary manifestations of M pneumoniae are common and hematologic (thrombocytopenia, splenomegaly, disseminated intravascular coagulation, hemolytic anemia), dermatologic (stevens-johnson syndrome), gastrointestinal (vomiting, diarrhea, pancreatitis), renal (interstitial nephritis, glomerulonephritis), cardiac (pericarditis, myocarditis, pericardial effusion) and central nervous system (meningitis, transverse myelitis, polyradiculopathy, cerebellar ataxia, sensorineural hearing loss) complications can occur. observation. We describe the case of an adolescent girl with massive rhabdomyolysis associated with an infection caused by M pneumoniae. We briefly review the differential diagnosis of a patient presenting with acute rhabdomyolysis and discuss the use of a new polymerase chain reaction-based assay for direct detection of M pneumoniae in throat swab specimens. CONCLUSION. Clinicians should be aware of a possible association between rhabdomyolysis and infection with M pneumoniae and should consider testing for M pneumoniae when they are presented with a patient with idiopathic rhabdomyolysis. The new polymerase chain reaction-based assay for detection of M pneumoniae is a more accurate and more efficient method than traditional culture. ( info) |
| mycoplasma pneumoniae is a common cause of upper and lower respiratory tract infections of varying severity. It is also responsible for producing a wide spectrum of nonpulmonary manifestations including neurologic, hepatic, cardiac, and hematologic diseases. The neurologic manifestations are reported to be the most common nonpulmonary manifestations. We describe six patients demonstrating the protean neurologic manifestations of mycoplasma pneumoniae infections. Four patients presented with the central nervous system manifestations of pyramidal and extrapyramidal tract dysfunction, seizures, cognitive abnormalities, and cerebellar dysfunction. Two patients presented with transverse myelitis. The outcome of this condition ranges from normal to severe residual deficits. Increased awareness of this disease entity may facilitate early diagnosis and thereby expedite starting appropriate therapy that may modify the outcome. ( info) |
9/230. Mycoplasma-pneumoniae-induced thrombotic thrombocytopenic purpura. Thrombotic thrombocytopenic purpura (TTP) is a fatal disease characterized by widespread platelet aggregation, hemolytic anemia and fever with renal and neurological involvement. Different factors have been associated with the development of TTP, e.g. infections, pregnancy, chemotherapy, drug therapy and bone marrow transplantation. Recent data imply that all these different causes may induce the disease by decreasing the activity of the plasma von willebrand factor-cleaving protease resulting in unusually large von willebrand factor multimers that later on initiate the cascade of TTP. In this communication, we present a unique association between infection with mycoplasma pneumoniae and TTP. We believe that the emergence of antibodies that cross-react with Mycoplasma and the protease might elucidate in this case the pathogenesis of TTP. ( info) |
10/230. Two cases of fulminant mycoplasma pneumoniae pneumonia within 4 months. We report the clinical course and diagnostic findings in two patients with life-threatening mycoplasma pneumoniae (MP) pneumonia who were treated in the same hospital in the course of only 4 months. The patients were previously healthy adults, aged 31 and 37 years, respectively. In both of them severe complications occurred which coincided with the acute MP respiratory infection. ( info) |