A Case of Acute Disseminated Encephalomyelitis Presenting with Bilateral Optic Neuritis associated with Mycoplasma pneumoniae.
- Author:
Kyung Hye KEUM
1
;
Kye Hyang LEE
Author Information
1. Department of Pediatrics, College of Medicine, Daegu Catholic University, Daegu, Korea. rosalia@cu.ac.kr
- Publication Type:Case Report
- Keywords:
Optic neuritis;
Acute disseminated encephalomyelitis;
Mycoplasma pneumoniae;
Skin manifestations
- MeSH:
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
- From:
Journal of the Korean Child Neurology Society
2008;16(2):222-228
- CountryRepublic of Korea
- Language:English
-
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.
