Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

Jessica Kammer; Stefan Ziesing; Lukas Aguirre Davila; Eva Bültmann; Sabine Illsinger; Anibh M. Das; Dieter Haffner; Hans Hartmann

doi:10.1055/s-0036-1584325

Neuropediatrics, Inhaltsverzeichnis

Neuropediatrics 2016; 47(05): 308-317
DOI: 10.1055/s-0036-1584325

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

Authors

Jessica Kammer

¹Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
Stefan Ziesing

²Department of Microbiology and Hospital Hygiene, Hannover Medical School, Hannover, Germany
Lukas Aguirre Davila

³Department of Biostatistics, Hannover Medical School, Hannover, Germany
Eva Bültmann

⁴Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
Sabine Illsinger

¹Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
Anibh M. Das

¹Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
Dieter Haffner

¹Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
Hans Hartmann

¹Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany

Abstract

Objective In this retrospective study, we aimed to assess frequency, types, and long-term outcome of neurological disease during acute Mycoplasma pneumoniae (M. pneumoniae) infection in pediatric patients.

Materials and Methods Medical records of patients hospitalized with acute M. pneumoniae infection were reviewed. Possible risk factors were analyzed by uni- and multivariate regression. Patients with neurological symptoms were followed up by expanded disability status score (EDSS) and the cognitive problems in children and adolescents (KOPKJ) scale.

Results Out of 89 patients, 22 suffered from neurological symptoms and signs. Neurological disorders were diagnosed in 11 patients: (meningo-) encephalitis (n = 6), aseptic meningitis (n = 3), transverse myelitis (n = 1), and vestibular neuritis (n = 1), 11 patients had nonspecific neurological symptoms and signs. Multivariate logistic regression identified lower respiratory tract symptoms as a negative predictor (odds ratio [OR] = 0.1, p < 0.001), a preexisting immune deficit was associated with a trend for a decreased risk (OR = 0.12, p = 0.058). Long-term follow-up after a median of 5.1 years (range, 0.6–13 years) showed ongoing neurological deficits in the EDSS in 8/18, and in the KOPKJ in 7/17.

Conclusion Neurological symptoms occurred in 25% of hospitalized pediatric patients with M. pneumoniae infection. Outcome was often favorable, but significant sequels were reported by 45%.

Keywords

Mycoplasma pneumoniae - encephalitis - cerebellitis - hypersomnia - transverse myelitis - children

Volltext

Referenzen

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