J Korean Child Neurol Soc.  2008 Nov;16(2):222-228.

A Case of Acute Disseminated Encephalomyelitis Presenting with Bilateral Optic Neuritis associated with Mycoplasma pneumoniae

Affiliations
  • 1Department of Pediatrics, College of Medicine, Daegu Catholic University, Daegu, Korea. rosalia@cu.ac.kr

Abstract

Mycoplasma pneumoniae(M. pneumoniae) is a well-known human respiratory pathogen. It also affects various organ systems and causes extrapulmonary complications, including neurologic, cutaneous, hematologic and ophthalmologic complications. M. pneumoniae has been implicated in a number of immune-mediated neurological diseases, such as ADEM, Gullian- Barre syndrome, and transverse myelitis. We present a 5-year-old boy with bilateral optic neuritis related to ADEM and pruritic skin lesions simultaneously associated with M. pneumoniae infection. He developed a headache with decreased activity six weeks before admission. He had no respiratory symptoms. Cerebral MRI showed multiple bilateral subcortical white matter lesions, suggesting a radiologic diagnosis of ADEM. M. pneumoniae was positive serologically. The cerebrospinal fluid polymerase chain reaction for M. pneumoniae was negative. The treatment with intravenous high-dose steroids and oral clarithromycin resulted in the rapid recovery of the patients visual and cutaneous problems. He was found to have returned to his normal conditions in the follow-up examination. We believe that immune-mediated injury can explain all the clinical manifestations of our case, which are ADEM-associated optic neuritis and cutaneous lesions.

Keyword

Optic neuritis; Acute disseminated encephalomyelitis; Mycoplasma pneumoniae; Skin manifestations

MeSH Terms

Clarithromycin
Encephalomyelitis, Acute Disseminated
Follow-Up Studies
Headache
Humans
Mycoplasma
Mycoplasma pneumoniae
Myelitis, Transverse
Optic Neuritis
Pneumonia
Pneumonia, Mycoplasma
Polymerase Chain Reaction
Preschool Child
Skin
Skin Manifestations
Steroids
Clarithromycin
Steroids
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