2019 Volume 31 Issue 3 Pages 315-321
A man in his early thirties had been complaining of fever and fatigue similar to the common cold for four days before hospitalization. He developed psychomotor excitation, delusional mood and paranoid like schizophrenia on the day of admission. The patient was diagnosed with Mycoplasma pneumoniae upon examination, and treated with a course of antibiotics. Catatonic stupor, catalepsy, autonomic activation and myoclonic seizure were observed during hospitalization, and he was diagnosed with acute encephalopathy. Mycoplasma pneumoniae was not detected in the cerebrospinal fluid (CSF), whereas NMDA type GluR (ELISA) antibodies were detected in the blood and CSF. Thus, Anti N-methyl-D-aspartate (Anti-NMDA) receptor encephalitis was suspected because of characteristic clinical courses, limbic symptoms and examinations. Some of the encephalitis as central nervous system complications of Mycoplasma pneumoniae is considered a disorder caused by an autoimmune reaction. Anti-NMDA receptor encephalitis is caused by an autoimmune reaction in the same way. Thus, it is suspected that Anti-NMDA receptor encephalitis is associated with Mycoplasma pneumoniae.
