Neurologic Complications Associated with Mycoplasma pneumoniae Infection

ABSTRACT

PURPOSE: Mycoplasma pneumoniae is known to be a common respiratory pathogen in children and cause neurologic complications in some patients. The clinical spectrum of the neurologic complications is wide, ranging from mild meningeal signs to severe neurologic symptoms with poor outcomes. The overall mortality in patients with neurologic complications has been approximated upto 10% and significant residual deficits could develop in about one third of the patients. This study was done to recognize the neurologic complications associated with M. pneumoniae and possibly to improve therapy and outcome. METHODS: We reviewed retrospectively the medical records of 8 patients with neurologic complications associated with M. pneumoniae infection in the department of Pediatrics, Asan Medical Center, during the period of 6 months from October,1993 to March, 1994. And we compared these cases with total 165 patients diagnosed as M. pneumoniae infection during the same period. RESULTS: 1) Neurologic complications were seen in 8 children among 165 patients with M. pneumoniae infection. 2) Among 8 patients, 4 patients were diagnosed as meningitis, 2 patients as Guillain-Barr syndrome, and 2 patients as ADEM. 3) 4 patients with meningitis were treated by erythromycin and 2 Guillain-Barr syndrome patients by IV gamma globulin and plasmapheresis, and 2 ADEM patients by methylprednisone pulse therapy and supportive therapy, respectively. 4) All patients improved without any neurological sequelae. CONCLUSIONS: Although M. pneumoniae is a common and usually self-limited pathogen in children, various neurologic complications can occur in a small proportion of patients. Therefore, M. pnuemoniae is to be considered as one of the etiologic agents of neurologic diseases in children.