Abstract
A 28-year-old housewife was admitted to Seirei Hamamatsu Hospital on July 21, 1980 because of nonproductive cough, exertional dyspnea, weakness of legs and numbness of distal parts of extremities. She had been complaining of cough and low-grade fever since July 10, and one week before admission, the loss of sensation and numbness occured in both hands and feet. Neurological examination on admission revealed so-called glove and stocking type of paresthesia, hypesthesia in right anterior femoral region and motor weakness of bilateral legs. Lumbar puncture on the third hospital day yielded clear and colorless cerebrospinal fluid under normal pressure, containing 2 lymphocytes per cubic millimeter, 15mg. protein per 100ml and 52mg. glucose per 100ml. Rales were heard in both lungs and the chest x-ray film showed diffuse macular patterns throughout the lungs. Arterial blood gas studies with breathing room air showed PO2 of 72.0mmHg; PCO2 of 30.6mmHg. Sputum and cerebrospinal fluid cultures for bacteria or fungi were negative, but the culture for Mycoplasma pneumoniae were technically impossible in our hospital. Serologic studies on admission showed a cold agglutinin titer of 1:256 dilutions and the Mycoplasma complement fixation titer of 1:2048. Complement fixation titers to other various virus showed no increase. 200mg of doxycycline hydrochloride was administered daily since the third hospital day. On the sixth hospital day, respiratory symptoms and paresthesia had disappeared and the diffuse macular infiltrate on the chest x-ray film showed nearly complete resolution. On the other hand, the hypesthesia spreaded to still more distal and posterior parts of right leg, and moved to the left leg, but disappeared within a month.
