Serveur d'exploration MERS

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Mycoplasma pneumoniae-associated mild encephalitis/encephalopathy with a reversible splenial lesion: report of two pediatric cases and a comprehensive literature review

Identifieur interne : 000314 ( Pmc/Curation ); précédent : 000313; suivant : 000315

Mycoplasma pneumoniae-associated mild encephalitis/encephalopathy with a reversible splenial lesion: report of two pediatric cases and a comprehensive literature review

Auteurs : Norishi Ueda ; Satoshi Minami ; Manabu Akimoto

Source :

RBID : PMC:5106775

Abstract

Background

No literature review exists on Mycoplasma pneumoniae-associated mild encephalitis/encepharopathy with a reversible splenial lesion (MERS).

Methods

M.pneumoniae-associated MERS cases were searched till August 2016 using PubMed/Google for English/other-language publications and Ichushi (http://www.jamas.or.jp/) for Japanese-language publications. Inclusion criteria were children fulfilling definition for encephalitis, M.pneumoniae infection, and neuroimaging showing hyperintensity in the splenium of the corpus callosum (SCC) alone (type I) or SCC/other brain areas (type II).

Results

We described two children with type I and II M.pneumoniae-associated MERS. Thirteen cases found by the search and our 2 cases were reviewed. Mean age, male/female ratio, duration of prodromal illness was 8.3 years, 1.5 and 3.5 days. The most common neurological symptom was drowsiness, followed by abnormal speech/behavior, ataxia, seizure, delirium, confusion, tremor, hallucination, irritability, muscle weakness, and facial nerve paralysis. Fever was the most common non-neurological symptom, followed by cough, headache, gastrointestinal symptoms, headache, lethargy and dizziness. Seizure and respiratory symptoms were less common. All were diagnosed for M.pneumoniae by serology. Cerebrospinal fluid (CSF) M.pneumoniae was undetectable by PCR in the 3 patients. Three patients were clarithromycin-resistant. Leukocytosis, positive C-reactive protein, hyponatremia, CSF pleocytosis and slow wave on electroencephalography frequently occurred. All except 2 were type I MERS. Neuroimaging abnormalities disappeared within 18 days in the majority of patients. All type I patients completely recovered within 19 days. Two type II patients developed neurological sequelae, which recovered 2 and 6 months after onset.

Conclusions

Prognosis of M.pneumoniae-associated MERS is excellent. Type II MERS may increase a risk of neurological sequelae.


Url:
DOI: 10.1186/s12879-016-1985-1
PubMed: 27836006
PubMed Central: 5106775

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PMC:5106775

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Norishi Ueda
<affiliation>
<nlm:aff id="Aff1">Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, 924-8588 Ishikawa Japan</nlm:aff>
<wicri:noCountry code="subfield">924-8588 Ishikawa Japan</wicri:noCountry>
</affiliation>
Satoshi Minami
<affiliation>
<nlm:aff id="Aff1">Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, 924-8588 Ishikawa Japan</nlm:aff>
<wicri:noCountry code="subfield">924-8588 Ishikawa Japan</wicri:noCountry>
</affiliation>
Manabu Akimoto
<affiliation>
<nlm:aff id="Aff2">Department of Radiology, Public Central Hospital of Matto Ishikawa, Hakusan, Ishikawa Japan</nlm:aff>
<wicri:noCountry code="subfield">Ishikawa Japan</wicri:noCountry>
</affiliation>

Le document en format XML

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<name sortKey="Ueda, Norishi" sort="Ueda, Norishi" uniqKey="Ueda N" first="Norishi" last="Ueda">Norishi Ueda</name>
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<nlm:aff id="Aff1">Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, 924-8588 Ishikawa Japan</nlm:aff>
<wicri:noCountry code="subfield">924-8588 Ishikawa Japan</wicri:noCountry>
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<name sortKey="Minami, Satoshi" sort="Minami, Satoshi" uniqKey="Minami S" first="Satoshi" last="Minami">Satoshi Minami</name>
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<italic>Mycoplasma pneumoniae</italic>
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<name sortKey="Ueda, Norishi" sort="Ueda, Norishi" uniqKey="Ueda N" first="Norishi" last="Ueda">Norishi Ueda</name>
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<nlm:aff id="Aff1">Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, 924-8588 Ishikawa Japan</nlm:aff>
<wicri:noCountry code="subfield">924-8588 Ishikawa Japan</wicri:noCountry>
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<name sortKey="Minami, Satoshi" sort="Minami, Satoshi" uniqKey="Minami S" first="Satoshi" last="Minami">Satoshi Minami</name>
<affiliation>
<nlm:aff id="Aff1">Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, 924-8588 Ishikawa Japan</nlm:aff>
<wicri:noCountry code="subfield">924-8588 Ishikawa Japan</wicri:noCountry>
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<name sortKey="Akimoto, Manabu" sort="Akimoto, Manabu" uniqKey="Akimoto M" first="Manabu" last="Akimoto">Manabu Akimoto</name>
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<wicri:noCountry code="subfield">Ishikawa Japan</wicri:noCountry>
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<title level="j">BMC Infectious Diseases</title>
<idno type="eISSN">1471-2334</idno>
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<title>Background</title>
<p>No literature review exists on
<italic>Mycoplasma pneumoniae</italic>
-associated mild encephalitis/encepharopathy with a reversible splenial lesion (MERS).</p>
</sec>
<sec>
<title>Methods</title>
<p>
<italic>M.pneumoniae</italic>
-associated MERS cases were searched till August 2016 using PubMed/Google for English/other-language publications and Ichushi (
<ext-link ext-link-type="uri" xlink:href="http://www.jamas.or.jp/">http://www.jamas.or.jp/</ext-link>
) for Japanese-language publications. Inclusion criteria were children fulfilling definition for encephalitis,
<italic>M.pneumoniae</italic>
infection, and neuroimaging showing hyperintensity in the splenium of the corpus callosum (SCC) alone (type I) or SCC/other brain areas (type II).</p>
</sec>
<sec>
<title>Results</title>
<p>We described two children with type I and II
<italic>M.pneumoniae</italic>
-associated MERS. Thirteen cases found by the search and our 2 cases were reviewed. Mean age, male/female ratio, duration of prodromal illness was 8.3 years, 1.5 and 3.5 days. The most common neurological symptom was drowsiness, followed by abnormal speech/behavior, ataxia, seizure, delirium, confusion, tremor, hallucination, irritability, muscle weakness, and facial nerve paralysis. Fever was the most common non-neurological symptom, followed by cough, headache, gastrointestinal symptoms, headache, lethargy and dizziness. Seizure and respiratory symptoms were less common. All were diagnosed for
<italic>M.pneumoniae</italic>
by serology. Cerebrospinal fluid (CSF)
<italic>M.pneumoniae</italic>
was undetectable by PCR in the 3 patients. Three patients were clarithromycin-resistant. Leukocytosis, positive C-reactive protein, hyponatremia, CSF pleocytosis and slow wave on electroencephalography frequently occurred. All except 2 were type I MERS. Neuroimaging abnormalities disappeared within 18 days in the majority of patients. All type I patients completely recovered within 19 days. Two type II patients developed neurological sequelae, which recovered 2 and 6 months after onset.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>Prognosis of
<italic>M.pneumoniae</italic>
-associated MERS is excellent. Type II MERS may increase a risk of neurological sequelae.</p>
</sec>
</div>
</front>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id>
<journal-title-group>
<journal-title>BMC Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2334</issn>
<publisher>
<publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27836006</article-id>
<article-id pub-id-type="pmc">5106775</article-id>
<article-id pub-id-type="publisher-id">1985</article-id>
<article-id pub-id-type="doi">10.1186/s12879-016-1985-1</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>
<italic>Mycoplasma pneumoniae</italic>
-associated mild encephalitis/encephalopathy with a reversible splenial lesion: report of two pediatric cases and a comprehensive literature review</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Ueda</surname>
<given-names>Norishi</given-names>
</name>
<address>
<phone>+81-76-275-2222</phone>
<email>nueda@mattohp.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Minami</surname>
<given-names>Satoshi</given-names>
</name>
<address>
<email>mina-mh@imcc-med.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Akimoto</surname>
<given-names>Manabu</given-names>
</name>
<address>
<email>akimoto@mattohp.com</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<aff id="Aff1">
<label>1</label>
Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, 924-8588 Ishikawa Japan</aff>
<aff id="Aff2">
<label>2</label>
Department of Radiology, Public Central Hospital of Matto Ishikawa, Hakusan, Ishikawa Japan</aff>
</contrib-group>
<pub-date pub-type="epub">
<day>11</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>11</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection">
<year>2016</year>
</pub-date>
<volume>16</volume>
<elocation-id>671</elocation-id>
<history>
<date date-type="received">
<day>1</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>27</day>
<month>10</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>© The Author(s). 2016</copyright-statement>
<license license-type="OpenAccess">
<license-p>
<bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1">
<sec>
<title>Background</title>
<p>No literature review exists on
<italic>Mycoplasma pneumoniae</italic>
-associated mild encephalitis/encepharopathy with a reversible splenial lesion (MERS).</p>
</sec>
<sec>
<title>Methods</title>
<p>
<italic>M.pneumoniae</italic>
-associated MERS cases were searched till August 2016 using PubMed/Google for English/other-language publications and Ichushi (
<ext-link ext-link-type="uri" xlink:href="http://www.jamas.or.jp/">http://www.jamas.or.jp/</ext-link>
) for Japanese-language publications. Inclusion criteria were children fulfilling definition for encephalitis,
<italic>M.pneumoniae</italic>
infection, and neuroimaging showing hyperintensity in the splenium of the corpus callosum (SCC) alone (type I) or SCC/other brain areas (type II).</p>
</sec>
<sec>
<title>Results</title>
<p>We described two children with type I and II
<italic>M.pneumoniae</italic>
-associated MERS. Thirteen cases found by the search and our 2 cases were reviewed. Mean age, male/female ratio, duration of prodromal illness was 8.3 years, 1.5 and 3.5 days. The most common neurological symptom was drowsiness, followed by abnormal speech/behavior, ataxia, seizure, delirium, confusion, tremor, hallucination, irritability, muscle weakness, and facial nerve paralysis. Fever was the most common non-neurological symptom, followed by cough, headache, gastrointestinal symptoms, headache, lethargy and dizziness. Seizure and respiratory symptoms were less common. All were diagnosed for
<italic>M.pneumoniae</italic>
by serology. Cerebrospinal fluid (CSF)
<italic>M.pneumoniae</italic>
was undetectable by PCR in the 3 patients. Three patients were clarithromycin-resistant. Leukocytosis, positive C-reactive protein, hyponatremia, CSF pleocytosis and slow wave on electroencephalography frequently occurred. All except 2 were type I MERS. Neuroimaging abnormalities disappeared within 18 days in the majority of patients. All type I patients completely recovered within 19 days. Two type II patients developed neurological sequelae, which recovered 2 and 6 months after onset.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>Prognosis of
<italic>M.pneumoniae</italic>
-associated MERS is excellent. Type II MERS may increase a risk of neurological sequelae.</p>
</sec>
</abstract>
<kwd-group xml:lang="en">
<title>Keywords</title>
<kwd>Encephalitis</kwd>
<kwd>MERS</kwd>
<kwd>Neuroimaging</kwd>
<kwd>
<italic>Mycoplasma pneumoniae</italic>
</kwd>
<kwd>Splenium of the corpus callosum</kwd>
</kwd-group>
<custom-meta-group>
<custom-meta>
<meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2016</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>

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