1/35. Fulminant form of acute disseminated encephalomyelitis: successful treatment with hypothermia.We described herein a case of the fulminant form of acute disseminated encephalomyelitis (ADEM) that developed after mycoplasma pneumonia. A 28-year-old man who presented with fever, headache, and writing difficulty was admitted to our hospital in August 1997. He developed hernia on the 3rd hospital day. Surgical decompression and intravenous prednisolone failed to halt his progressive deterioration. We introduced systemic hypothermia and he has shown marked recovery; despite having Broca's type aphasia, he could comprehend spoken language and communicate with others by gesture. Head MRI demonstrated diffuse high signals over the white matter on fluid attenuated inversion recovery (FLAIR) images, which suggested extensive demyelination. The clinical course, imaging studies and presence of polymorphonuclear dominant leucocytosis in the blood and CSF in the patient are somewhat similar to findings in acute hemorrhagic leukoencephalitis, however, the result of a brain biopsy was inconclusive. The fulminant form of ADEM is usually fatal. Treatments such as corticosteroids, intravenous immunoglobulin, and surgical decompression have been performed to improve the prognosis. Our case results indicate that hypothermia, which suppresses both brain edema and immune response, may be included in the repertoire of treatment for the fulminant form of ADEM.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/35. Encephalitis caused directly by mycoplasma pneumoniae.A case of non-fatal encephalitis in a 21-y-old immunocompetent woman is described. High titre serum antibodies against mycoplasma pneumoniae were found. In addition, mycoplasma pneumoniae dna was detected in the cerebrospinal fluid by polymerase chain reaction. neuroimaging findings by magnetic resonance and computed tomographic scanning of the brain, and laboratory investigations, including a search for serum antibodies to gangliosides, did not support an immune-mediated mechanism. No other pathogens were found. These results strongly suggest that the encephalitis was caused directly by mycoplasma pneumoniae invasion of the central nervous system. They also indicate that such pathogenetic mechanism may sometimes be sufficient to explain neurological manifestations occurring during the course of mycoplasma pneumoniae infection. The consequences for therapy are discussed.- - - - - - - - - - ranking = 28.33660693362keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
3/35. rhabdomyolysis associated with infection by mycoplasma pneumoniae: a case report.BACKGROUND. mycoplasma pneumoniae is responsible for approximately 20% of the cases of community-acquired pneumonia. The onset of respiratory symptoms is gradual and systemic complaints such as headache, malaise, arthalgias, and low-grade fever are frequently prominent. Extrapulmonary manifestations of M pneumoniae are common and hematologic (thrombocytopenia, splenomegaly, disseminated intravascular coagulation, hemolytic anemia), dermatologic (stevens-johnson syndrome), gastrointestinal (vomiting, diarrhea, pancreatitis), renal (interstitial nephritis, glomerulonephritis), cardiac (pericarditis, myocarditis, pericardial effusion) and central nervous system (meningitis, transverse myelitis, polyradiculopathy, cerebellar ataxia, sensorineural hearing loss) complications can occur. observation. We describe the case of an adolescent girl with massive rhabdomyolysis associated with an infection caused by M pneumoniae. We briefly review the differential diagnosis of a patient presenting with acute rhabdomyolysis and discuss the use of a new polymerase chain reaction-based assay for direct detection of M pneumoniae in throat swab specimens. CONCLUSION. Clinicians should be aware of a possible association between rhabdomyolysis and infection with M pneumoniae and should consider testing for M pneumoniae when they are presented with a patient with idiopathic rhabdomyolysis. The new polymerase chain reaction-based assay for detection of M pneumoniae is a more accurate and more efficient method than traditional culture.- - - - - - - - - - ranking = 27.83660693362keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/35. neurologic manifestations of mycoplasma pneumoniae infections: diverse spectrum of diseases. A report of six cases and review of the literature.mycoplasma pneumoniae is a common cause of upper and lower respiratory tract infections of varying severity. It is also responsible for producing a wide spectrum of nonpulmonary manifestations including neurologic, hepatic, cardiac, and hematologic diseases. The neurologic manifestations are reported to be the most common nonpulmonary manifestations. We describe six patients demonstrating the protean neurologic manifestations of mycoplasma pneumoniae infections. Four patients presented with the central nervous system manifestations of pyramidal and extrapyramidal tract dysfunction, seizures, cognitive abnormalities, and cerebellar dysfunction. Two patients presented with transverse myelitis. The outcome of this condition ranges from normal to severe residual deficits. Increased awareness of this disease entity may facilitate early diagnosis and thereby expedite starting appropriate therapy that may modify the outcome.- - - - - - - - - - ranking = 27.83660693362keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/35. Methyl-prednisolone in neurologic complications of Mycoplasma pneumonia.In patients with Mycoplasma pneumonia extrapulmonary manifestations such as encephalitis, meningitis, cerebellar and brain stem involvement, cranial nerve lesions, peripheral neuropathy, polymyositis have been observed. We report a 16-year-old girl with M. pneumonia infection, acute behavioral changes and coma. Treatment with high dose methyl-prednisolone and clarithromycin led to rapid clinical improvement.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
6/35. Brainstem and striatal encephalitis complicating mycoplasma pneumoniae pneumonia: possible benefit of intravenous immunoglobulin.Encephalitides of the brainstem and the striatum associated with mycoplasma pneumoniae infection are believed to be mediated by an autoimmune process triggered by the organism, a toxin or direct invasion by the organism itself. Inability to identify M. pneumoniae from cerebrospinal fluid by culture or polymerase chain reaction suggested a possible immunologic process. A trial of intravenous immunoglobulin in a critically ill patient with encephalitis that developed in parallel to M. pneumoniae pneumonia was associated with neurologic improvement within 48 h of treatment.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
7/35. mycoplasma pneumoniae infection, meningoencephalitis, and hemophagocytosis.central nervous system manifestations are a common extrapulmonary complication of mycoplasma pneumoniae infection, of which encephalitis is a well-recognized abnormality in children. In this report the first description of M. pneumoniae infection simultaneously complicated by meningoencephalitis and hemophagocytosis is presented.- - - - - - - - - - ranking = 8.7869817790916keywords = nervous system (Clic here for more details about this article) |
8/35. Detection of mycoplasma pneumoniae dna in cerebrospinal fluid of a patient with M. pneumoniae infection-"associated" stroke.A 36-year-old woman presented with an acute ischemic stroke and a concomitant mycoplasma pneumoniae infection that had been proven clinically, bacteriologically, and serologically. M. pneumoniae dna was demonstrated in cerebrospinal fluid by positive nested polymerase chain reaction, and intrathecal antibody production was also detected. Contrary to previous reports about M. pneumoniae-associated stroke, most thrombostatic abnormalities in this patient occurred after stroke onset. Although the cause of stroke remains unclear in this patient, central nervous system invasion of M. pneumoniae dna has to be considered a possible cause in rare cases of cerebral ischemia.- - - - - - - - - - ranking = 27.83660693362keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/35. Post-infectious central and peripheral nervous system diseases complicating mycoplasma pneumoniae infection. Report of three cases and review of the literature.Three patients with a central and peripheral nervous system disease complicating a mycoplasma pneumoniae (M. pn.) infection are presented. Patient 1 suffered from bilateral optic neuritis as well as acute guillain-barre syndrome recovering after plasmapheresis. The two other patients suffered from severe haemorrhagic leukoencephalitis (Hurst) which only could be contained by aggressive decompressive craniectomy with duraplasty. All three illnesses were clearly shown to be associated with M. pn. infection.Our three patients represent the full scale of central nervous (CNS) (cerebral and myelitic) as well as peripheral nervous system (PNS) (GBS, optic neuritis) manifestation of a disease caused by the same pathogenetic - post-infectious - mechanism; pathogenic CNS and PNS epitopes might be shared in post-infectious neurological disease following M. pn. infection.- - - - - - - - - - ranking = 52.72189067455keywords = nervous system (Clic here for more details about this article) |
10/35. posterior cerebral artery occlusion associated with mycoplasma pneumoniae infection.cerebral infarction is a rare complication of mycoplasma pneumoniae infection. In all cases previously reported in the literature, vascular occlusion occurred in the anterior brain circulation, either the internal carotid or the middle cerebral artery. We report a case of a child with posterior cerebral artery occlusion and resultant hemiparesis associated with M. pneumoniae infection.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
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