Mycoplasma Pneumoniae Infection Associated With Central Nervous System Complications

Fernandez, Conrad V.; Bortolussi, Robert; Gordon, Kevin; Lee, Spencer H. S.; Gatien, John G.; Shahdrabadi, M.S.

doi:10.1177/088307389300800104

Cited by 28 publications

(19 citation statements)

References 38 publications

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“…Considering the clinical course, imaging studies, and negative culture studies, the neurologic manifestations of at least some of these patients were believed to be immune or toxin mediated (7,11,14,17) rather than due to direct invasion of the organism.…”

Section: Discussionmentioning

confidence: 99%

“…Although diagnosis of MP infection requires fourfold rising of the serologic titer (17), temporal relationship of MP antibody titer with clinical and radiological changes suggests that the patient's neurologic symptoms are related to MP infection. All other investigations were nonrevealing, and the clinical course of this patient excluded the possibility of mitochondria1 cytopathy or other progressive metabolic disorders.In the literature, neurologic manifestations associated with MP infection include meningitis (2), meningoencephalitis (2,3,7,9,10,14), encephalomyelitis ( 1 3 , psychosis (l), seizures (3,12,14,16), polyradiculitis (2,3,13), acute cerebellar ataxia (3, brain stem dysfunction (4), and myelitis (6,ll). Considering the clinical course, imaging studies, and negative culture studies, the neurologic manifestations of at least some of these patients were believed to be immune or toxin mediated (7,11,14,17) rather than due to direct invasion of the organism.…”

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confidence: 99%

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Reversible parkinsonism and dystonia following probable mycoplasma pneumoniae infection

1995

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Infectious disease is a rare cause of parkinsonism. We report a 7-year-old boy who developed flu-like symptoms followed by parkinsonian features including hypophonia, hypomimia, bradykinesia, and dystonia. A T2-weighted brain magnetic resonance imaging showed high signal intensities in both basal ganglia. The results of serial serologic tests of Mycoplasma pneumonia antibody suggest that this movement disorder was associated with Mycoplasma pneumonia infection. The patient's symptoms gradually resolved, and the basal ganglionic lesions disappeared on follow-up magnetic resonance imaging.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Reversible parkinsonism and dystonia following probable mycoplasma pneumoniae infection

1995

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“…It is the most common cause of primary atypical pneumonia resistant to ␤-lactam antibiotics in older children and young adults (5,10,15). M. pneumoniae can also be associated with severe extrapulmonary complications (9,21,24). The standard laboratory methods for the specific diagnosis of M. pneumoniae infection have been isolation in culture and serological methods.…”

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confidence: 99%

Evaluation of Four Commercial Immunoglobulin G (IgG)- and IgM-Specific Enzyme Immunoassays for Diagnosis of Mycoplasma pneumoniae Infections

Petitjean¹,

Vabret²,

Gouarin³

et al. 2002

J Clin Microbiol

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routine diagnosis. A good concordance of IgG seroprevalence in healthy adults was found between the four EIAs (66 to 70%), though this concordance was lower with EIA-Platelia (43%). In healthy children, EIA-BMD and EIA-Biotest gave a higher IgG seroprevalence than EIA-Sorin and EIA-Platelia (45% each for the former compared to 17 and 20%, respectively, for the latter). These results confirm that the IgM EIA serology test is a valuable tool for the early diagnosis of M. pneumoniae infections in children, as long as the EIA used is specific. In adults, the difficult interpretation of EIAs suggests that paired sera, combined with PCR detection on respiratory tract specimens collected on admission of patient, should be required for accurate diagnosis.Mycoplasma pneumoniae is a common respiratory pathogen responsible for mild acute respiratory infections such as sore throats, pharyngitis, and tracheobronchitis in younger children. It is the most common cause of primary atypical pneumonia resistant to ␤-lactam antibiotics in older children and young adults (5,10,15). M. pneumoniae can also be associated with severe extrapulmonary complications (9, 21, 24). The standard laboratory methods for the specific diagnosis of M. pneumoniae infection have been isolation in culture and serological methods. Culture is time-consuming and relatively insensitive. The conventional complement fixation test (CFT) using a glycolipid antigen gives unspecific reactions and lacks sensitivity (16,19). Alternative tests have recently been developed to obtain moreaccurate and prompt diagnosis: indirect enzyme immunoassay (EIA) measuring separately immunoglobulin G (IgG) and IgM class antibodies (8,14,27,33,35) and PCR for rapid and sensitive detection of M. pneumoniae in respiratory tract specimens (1,4,6,31,32,36). The objective of this retrospective study was to compare the performance of four commercially available EIAs for the detection of specific M. pneumoniae IgG and IgM antibodies in assessing the antibody response of suspected M. pneumoniae patients on the basis of PCR-positive results for M. pneumoniae in respiratory samples. Furthermore, we evaluated the ability of the serological tests to accurately establish an earlier serodiagnosis of M. pneumoniae infections. MATERIALS AND METHODSPatients and controls. For a 4-year period, January 1997 through December 2000, 39 patients (group I: 27 children and 12 adults), admitted to Caen's hospital with clinical features of upper or lower respiratory tract infection consistent with M. pneumoniae infection, were retrospectively selected on the basis of a specific M. pneumoniae-positive PCR in respiratory tract samples. Serum specimens and respiratory tract specimens were obtained on admission from all 39 patients. In addition, serum specimens were obtained 5 to 22 days later from 13 patients. Upon their receipt, the 52 serum samples were serologically investigated for M. pneumonia-specific IgM and IgG antibodies by the Platelia EIAs IgG and IgM (Diagnostica Pasteur Sanofi) (referred to herein...

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“…The definite etiopathogenic mechanism is unknown. Several pathogenic theories have been put forth in recent years, including direct neuroinvasion, neurotoxin elaboration, hypercoagulable state and infection leading to immune dysfunction, such as autoantibodies production [5, 44–46]. It is possible that multiple mechanisms may be occurring simultaneously.…”

Section: Discussionmentioning

confidence: 99%

The association between Mycoplasma pneumoniae infection and speech and language impairment: A nationwide population-based study in Taiwan

et al. 2017

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Manifestations of Mycoplasma pneumoniae infection can range from self-limiting upper respiratory symptoms to various neurological complications, including speech and language impairment. But an association between Mycoplasma pneumoniae infection and speech and language impairment has not been sufficiently explored. In this study, we aim to investigate the association between Mycoplasma pneumoniae infection and subsequent speech and language impairment in a nationwide population-based sample using Taiwan’s National Health Insurance Research Database. We identified 5,406 children with Mycoplasma pneumoniae infection (International Classification of Disease, Revision 9, Clinical Modification code 4830) and compared to 21,624 age-, sex-, urban- and income-matched controls on subsequent speech and language impairment. The mean follow-up interval for all subjects was 6.44 years (standard deviation = 2.42 years); the mean latency period between the initial Mycoplasma pneumoniae infection and presence of speech and language impairment was 1.96 years (standard deviation = 1.64 years). The results showed that Mycoplasma pneumoniae infection was significantly associated with greater incidence of speech and language impairment [hazard ratio (HR) = 1.49, 95% CI: 1.23–1.80]. In addition, significantly increased hazard ratio of subsequent speech and language impairment in the groups younger than 6 years old and no significant difference in the groups over the age of 6 years were found (HR = 1.43, 95% CI:1.09–1.88 for age 0–3 years group; HR = 1.67, 95% CI: 1.25–2.23 for age 4–5 years group; HR = 1.14, 95% CI: 0.54–2.39 for age 6–7 years group; and HR = 0.83, 95% CI:0.23–2.92 for age 8–18 years group). In conclusion, Mycoplasma pneumoniae infection is temporally associated with incident speech and language impairment.

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Mycoplasma Pneumoniae Infection Associated With Central Nervous System Complications

Cited by 28 publications

References 38 publications

Reversible parkinsonism and dystonia following probable mycoplasma pneumoniae infection

Reversible parkinsonism and dystonia following probable mycoplasma pneumoniae infection

Evaluation of Four Commercial Immunoglobulin G (IgG)- and IgM-Specific Enzyme Immunoassays for Diagnosis of Mycoplasma pneumoniae Infections

The association between Mycoplasma pneumoniae infection and speech and language impairment: A nationwide population-based study in Taiwan

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