2018 Volume 50 Issue 1 Pages 50-54
Objective: We examined the clinical features of pediatric patients with Mycoplasma pneumoniae-associated encephalitis/encephalopathy. Methods: We retrospectively evaluated 0-15-year-old patients hospitalized for M. pneumoniae-associated encephalitis/encephalopathy to our hospital or to an affiliated hospital between 2010 and 2016. Results: There were six males and two females aged 2-14 years. They were categorized into two groups : early-onset type (n=2) in which neurological sympoms developed within 3 days of fever or cough onset and late-onset type (n=6) in which neurological symptoms developed 10 days after their onset. The early-onset group included two patients with mild encephalitis with a reversible splenial lesion (MERS). The late-onset group included three patients with autoimmune limbic encephalitis, one with acute disseminated encephalomyelitis, one with Bickerstaff’s brainstem encephalitis, and one with unclassified encephalopathy. Although these six patients completely recovered without sequela, dysarthria persisted in one patient with MERS and cerebellar lesions. Mild intellectual impairment persisted in one patient with limbic encephalitis. Conclusion: As prodromal respiratory symptoms were not outstanding in some studied patients, M. pneumoniae infection should be considered in patients with encephalitis/encephalopathy of unknown etiology. Although there are few clinical reports from Japan, further clinical investigations are expected given the recent development of sensitive diagnostic procedures such as loop-mediated isothermal amplification assay.
