Clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with Mycoplasma pneumoniae infection

BMC Infectious Diseases

Case Report

Feng Gao¹  Jue Shen¹  Pei-Fang Jiang¹  Shan-Shan Mao¹  Zhe-Feng Yuan¹  Lu Xu¹  Yong-Lin Yu¹  Zhe-Zhi Xia¹ 

[1] Department of neurology, The Children’s Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, 310003, Hangzhou, Zhejiang Province, China;

关键词: MERS;    Mycoplasma pneumoniae;    Corpus callosum;    Encephalopathy;   

DOI  :  10.1186/s12879-016-1556-5

 received in 2015-12-09, accepted in 2016-05-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundClinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome characterized by transient mild symptoms of encephalopathy and a reversible lesion in the splenium of the corpus callosum on magnetic resonance imaging (MRI). It is often triggered by infection. The common pathogens of MERS are viruses, especially influenza virus. However, Mycoplasma pneumoniae (M.pneumoniae) are relatively rare pathogens for MERS.Case presentationHere we report two paediatric cases of M.pneumoniae infection-induced MERS. The diagnosis of M.pneumoniae infection was established based on polymerase chain reaction (PCR) and specific serum antibodies (IgM). Both of the two patients presented with mild encephalopathy manifestations and recovered completely within a few days. The initial MRI showed a lesion in the central portion of the splenium of the corpus callosum, which completely resolved on the seventh and eighth day after admission for case 1 and case 2. Lumbar puncture was performed in both patients, which revealed no pleocytosis. In case 1, the patient had hyponatremia, peripheral facial nerve paralysis, and rash. To the best of our knowledge, it is the first MERS case associated with peripheral nerve damage. In case 2, interleukin-6(IL-6) was moderately increased in the cerebrospinal fluid (CSF). It suggested that IL-6 may play a role in the pathogenesis of M.pneumoniae-induced MERS.ConclusionOur study enriches the available information on the pathogens of MERS and provides valuable data for better understanding of this syndrome.

【 授权许可】

CC BY   
© Yuan et al. 2016