Korean J Pediatr.  2016 Mar;59(3):149-152. 10.3345/kjp.2016.59.3.149.

Complete occlusion of the right middle cerebral artery associated with Mycoplasma pneumoniae pneumonia

• Kang B
• Kim DH
• Hong YJ
• Son BK
• Lim MK
• Choe YH
• Kwon YS

• KMID: 2163060
• DOI: http://doi.org/10.3345/kjp.2016.59.3.149

Abstract

We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed complete occlusion of the right middle cerebral artery. Mycoplasma pneumoniae infection was identified by a 4-fold increase in IgG antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. Fibrinogen and D-dimer levels were elevated, while laboratory exams in order to identify other predisposing factors of pediatric stroke were all negative. This is the first reported pediatric case in English literature of a M. pneumoniae-associated cerebral infarction involving complete occlusion of the right middle cerebral artery.

Keyword

Cerebral infarction; Middle cerebral artery infarction; Mycoplasma pneumoniae

MeSH Terms

Antibodies
Brain
Causality
Cerebral Angiography
Cerebral Infarction
Child, Preschool
Enzyme-Linked Immunosorbent Assay
Facial Paralysis
Female
Fever
Fibrinogen
Humans
Immunoglobulin G
Infarction
Infarction, Middle Cerebral Artery
Lung
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Middle Cerebral Artery*
Mycoplasma pneumoniae*
Mycoplasma*
Paresis
Pleural Effusion
Pneumonia*
Pneumonia, Mycoplasma*
Radiography
Stroke
Thorax
Antibodies
Fibrinogen
Immunoglobulin G