No se diagnostica aquello que no se piensa. ¿Cuándo pensar encefalitis por Mycoplasma?

Introduction

Encephalitis is defined as inflammation of the brain parenchyma. It can have multiple infectious and non-infectious etiologies. Mycoplasma pneumoniae is a prevalent respiratory pathogen that can manifest with central nervous system (CNS) involvement.

Objective

To present a series of adult patients with encephalitis whose etiological studies suggest M. pneumoniae as a potential causal agent.

Materials and methods

A review of medical records from 2013 to 2023 was conducted, focusing on patients with clear cerebrospinal fluid (CSF) meningoencephalitis. After ruling out other etiologies, M. pneumoniae infection was identified as a possible explanation.

Results

Between 2013 and 2023, 11 adult patients were identified, 6 of whom were male and 5 female, with a mean age of 30.72 years (SD ± 17). Three patients presented with symptoms consistent with rhombencephalitis, while eight manifested as meningoencephalitis. Seventy-three percent of the patients reported preceding respiratory symptoms. Thirty percent showed leptomeningeal enhancement, and another 30% displayed T2 hyperintensities.

Conclusion

The most frequent profile in our population consisted of patients with clinical features consistent with encephalitis or rhombencephalitis, pleocytosis, and hyperproteinorrhachia below 1 g/l, with leptomeningeal enhancement on MRI and a history of respiratory tract infection within the previous 20 days.