Mycoplasma pneumonia as a cause of neuromyelitis optica?

Abstract

On the other hand, several neurological manifestations have been described following Mycoplasma pneumonia [4,5] infection, a common bacterium of the respiratory tract, including acute transverse myelitis (ATM) [11].Here we present a patient with typical NMO after M. pneumonia infection that may represent an underestimated etiology for NMO. A previously healthy 32-year-old woman developed fever and a nonproductive cough. A chest x-ray showed an infiltrate in the right inferior lobe. Respiratory symptoms improved with erythromycin treatment. Ten days later she experienced paresthesia and weakness in both legs, urinary retention and was admitted to our department.On neurological examination she was alert. Cranial nerves were normal, but there was tetraparesis with tetrahyperreflexia and hypaesthesia with a sensory level at the 4 th thoracic level. No signs of meningism were present. Sphincter tone was reduced on rectal examination. The night after admission, the patient had to be transferred to our intensive care unit because of respiratory failure requiring intubation. MRI investigation revealed a severe myelitis (Fig.1A and B).CSF investigation showed 15 white blood cells per μL, 37 % polymorphonuclear neutrophils. There was no quantitative intrathecal immunoglobulin production.Serologic examinations showed a highly positive complement fixation test (CFT) to M. pneumonia (1:5120). An indirect immunofluorescence assay was used to search for M. pneumonia antibodies in CSF and serum. This investigation revealed an elevated titer of IgG antibodies specific to M. pneumonia in the CSF. In combination with an antibody specificity index of 9.5 these results indicate an intrathecal production of IgG antibodies specific to M. pneumonia. Neither in

Extensive hemispheric lesions with radiological evidence of blood–brain barrier integrity in a patient with neuromyelitis optica

“…Although the attack of ADEM itself (if it had occurred in isolation) would have prompted NMO-IgG testing due to the rare observation of lack of GDE, the patient had fulfilled the current NMO criteria at least a year before the ADEM episode [6]. Moreover, a post-Mycoplasma NMO case with seronegative NMO-IgG has been reported [14]. Therefore, it remains unclear whether or not NMO-IgG is associated with a post-Mycoplasma NMO episode.…”

Differential diagnosis of neuromyelitis optica spectrum disorders

“…164 Miscellaneous infections. Though rare, infections such as herpes virus (Herpes simplex, 165 Epstein-Barr virus, 166 and cytomegalovirus 167 ), human T-lymphotrophic virus 1 (HTLV-1), 168 dengue virus, 169 Borrelia burgdorferi (Lyme), 170 tuberculosis, 171 Mycoplasma pneumoniae, 172 and Streptococcus pneumoniae 15 can manifest as LETM and/or optic neuritis.…”

Comprehensive review of neuromyelitis optica and clinical characteristics of neuromyelitis optica patients in Puerto Rico

“…Syphilis is a sexually transmitted infection that can cause ON that can mimic NMOSD. [24197210252] Other infections that can mimic NMOSD include Epstein Barr virus,[11] herpes simplex virus,[190] cytomegalovirus,[267] human t-lymphocytic virus,[279] dengue fever,[147] lyme disease,[174] tuberculosis,[100] Mycoplasma pneumoniae ,[80] and Streptococcus pneumoniae . [238]…”