Reversible neurological syndromes with atypical pneumonia

Abstract

Simultaneous or sequential involvement of lungs is frequently encountered with neurological syndromes like meningoencephalitis, cerebellitis, aseptic meningitis, transverse myelitis, or multiple cranial nerve palsies. However, pulmonary involvement is frequently overlooked when all the attention of physician is diverted to neurological disorder. Prompt and early recognition of such potentially treatable association is required to improve diagnostic and therapeutic outcome. We report six patients presenting with various neurological manifestations like meningitis, meningoencephalitis, and myelits associated with atypical pneumonia. With proper clinical correlation and relevant investigations, all of them were diagnosed in time and had remarkable recovery with appropriate treatment.

Posterior Reversible Encephalopathy Syndrome (PRES) Secondary to Severe Pneumonia

“…We assume that PRES in a case with infection caused by gram negative bacteria is very rare. Mycoplasma pneumoniae, Legionella pneumophila are the commonest bacteria which are more capable of causing numerous extra pulmonary manifestations included neurological syndromes such as meningoencephalitis, aseptic meningitis, cerebellitis, cranial nerve palsies, polyradiculopathy [3]. But severe pneumonia causes PRES as a neurological consequence is not found in the current medical literature.…”

“…But severe pneumonia causes PRES as a neurological consequence is not found in the current medical literature. Neurological manifestations of pneumonia are frequently categorized under two groups such as neurological symptoms which occur parallel with respiratory symptoms and neurological symptoms which appear later following a gap [3]. Mechanisms of underling PRES in pneumonia and sepsis have not yet been elucidated [4,7].…”

“…Especially atypical pneumonia caused by Mycoplasma pneumonia and Legionella peumophila are more potential to associate with classic neurological manifestations such as meningoencephalitis, aseptic meningitis, myelitis, cranial nerve palsies. But severe pneumonia causes PRES as a neurological sequalae is a very rare association [3].…”

A Rare Case of Bilateral Optic Neuritis and Guillain-Barré Syndrome PostMycoplasma pneumoniaeInfection

“…Peripheral nervous system manifestations are less commonly described but include cranial nerve palsies, GBS, polyradiculitis, and peripheral neuropathy (Table 1). [1][2][3][4][5] Table 2 highlights all cases published (in English) of optic neuritis that has occurred post M. pneumoniae infection.…”

Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

“…When not recognised or treated it has high mortality and morbidity. Respiratory symptoms caused by pneumonia are frequent but atypical pneumonia usually also includes extrapulmonary organ involvement, such as neuropsychiatric symptoms [ 3 ]. We describe a case of a 61-year-old woman with no previous significant psychiatric history who presented with acute psychosis as major initial clinical picture of Legionnaires' disease during the Vila Franca de Xira, Portugal, outbreak in 2014.…”