Swiss national prospective surveillance of paediatric Mycoplasma pneumoniae-associated encephalitis.

Abstract:

OBJECTIVE:To assess the presence of Mycoplasma pneumoniae-associated encephalitis in children in Switzerland and its likely pathogenesis. METHODS:M. pneumoniae-associated encephalitis cases seen at a single-centre during 2010-2013 were reviewed, and the Swiss Paediatric Surveillance Unit (SPSU) prospectively conducted a nationwide surveillance 2013-2015. Case definition included confirmed, probable and possible cases. RESULTS:Seven patients (median age 8.7 years, range 4.7-10.1 years) with confirmed or possible M. pneumoniae-associated encephalitis were observed. All patients manifested prodromal respiratory symptoms over at least 5 days and five out of the six who had a chest radiograph, showed pulmonary infiltrates. M. pneumoniae DNA in cerebrospinal fluid was negative in all patients. Intrathecally synthesised M. pneumoniae-specific immunoglobulin (IgM and IgG) were investigated and found positive in one patient (confirmed case). M. pneumoniae DNA in respiratory specimens and/or M. pneumoniae-specific IgM and IgG in serum were detected in the other six patients (possible cases). One confirmed and two possible cases had neurological sequelae at 4-19 months follow-up. CONCLUSION:The lack of detectable M. pneumoniae DNA in cerebrospinal fluid of our encephalitis patients suggests a likely immune-mediated pathogenesis ignited by a respiratory inflammatory process including pneumonia.

journal_name

Swiss Med Wkly

journal_title

Swiss medical weekly

authors

Meyer Sauteur PM,Moeller A,Relly C,Berger C,Plecko B,Nadal D,Swiss Pediatric Surveillance Unit (SPSU).

doi

10.4414/smw.2016.14222

subject

Has Abstract

pub_date

2016-01-11 00:00:00

pages

w14222

eissn

1424-7860

issn

1424-3997

pii

smw-14222

journal_volume

146

pub_type

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