KMID : 0391520180260010077
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Journal of the Korean Child Neurology Society 2018 Volume.26 No. 1 p.77 ~ p.81
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A Case of Severe Encephalitis with Mycoplasma pneumoniae Infection in a 4-Year-Old Boy
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Lee Hyo-Eun
Lee Soo-Jin
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Abstract
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Mycoplasma pneumoniae (MP) infection can result in extrapulmonary and respiratory manifestations. The direct invasion by MP and the indirect invasion by immune-mediated response have been suggested as the pathogenesis of extrapulmonary manifestations. Neurologic manifestations are the most common among the extrapulmonary manifestations associated with MP infection. We report the case of a 4-year-old previously healthy boy with encephalitis accompanied by MP pneumonia. The patient¡¯s respiratory manifestations appeared 14 days before the neurological manifestations. Leukocytosis was observed in the patient¡¯s cerebrospinal fluid, but the result of the MP polymerase chain reaction was negative. The magnetic resonance imaging of the patient¡¯s brain showed high signal intensity at bilateral basal ganglia. The chest radiograph confirmed the presence of lobar pneumonia. The serological test on MP-specific immunoglobulin M titer revealed a positive result. The clinical course improved with the administration of immunomodulatory therapies, but the patient subsequently developed spastic quadriplegic cerebral palsy. MP is a common pathogen in children and may induce aggravating neurologic diseases. Thus, MP should be considered a causative agent of encephalitis in children. Immunomodulatory drugs are the recommended therapeutic option for severe MP encephalitis.
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KEYWORD
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Mycoplasma pneumoniae, Encephalitis
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