Abstract Details

Title The Neurologic Manifestations of M. pneumonia Infection in Children: A Prospective 15-Year Review

Topic Infections/AIDS/Prion Disease

Presentation(s) S16 - (-)

Poster/Presentation
Number 003

Objective

Background The association of M.pneumoniae infection with various neurological outcomes has been reported sporadically in the literature. In many of these reports, M. pneumoniae was implicated solely on the basis of serology.

Design/Methods The subjects were indentified via the Hospital for Sick Children's laboratory database and the encephalitis registry. Patients admitted between October 1996 and September 2011 with M. pneumoniae infection and acute neurologic manifestations were eligible for inclusion. M. pneumoniae infection was defined by detection of M. pneumoniae by polymerase chain reaction (PCR) in the cerebrospinal fluid (CSF) or in the respiratory tract.

Results Over 15 years, 318 children had M. pneumoniae detected in their CSF or respiratory tract by means of PCR. Of these, 48 (15%) had an acute neurological presentation; 35 (73%) were diagnosed with encephalitis/encephalopathy, 5 (10%) with transverse myelitis, 5 (10%) with acute disseminated encephalomyelitis, 2 (4%) with Guillain-Barre Syndrome and one (2%) with stroke. Thirty-three (69%) subjects had a preceding prodromal illness, with a median of 6 days prior to the onset of neurologic manifestations. Presenting features included fever (66%), cough (44%), seizures (37%) and focal neurological deficits (42%). An average of 33 white blood cells in the CSF was seen with a mean CSF protein level of 0.59. Abnormalities on neuroimaging were detected in 54% of cases. Twenty-one subjects had a co-existing infection or an alternative diagnosis.

Conclusions M. pneumoniae is associated with a variety of acute neurologic conditions, some of which are likely due to direct infection of the central nervous system and others a consequence of immune mediated phenomenon. We conclude that applying stringent microbiological criteria aids the clinician in identifying the cases in which M. pneumonia is likely the culprit. This may have treatment implications in the future.

Authors/Disclosures
Samiah A. Al-Zaidy, MD PRESENTER	Dr. Al-Zaidy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AveXis Inc.
Daune L. MacGregor, MD, FAAN (Hospital for Sick Children)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Vladimir Coric	Vladimir Coric has received personal compensation for serving as an employee of Biohaven. Vladimir Coric has received personal compensation in the range of $1,000,000+ for serving as an officer or member of the Board of Directors for Bioahven. Vladimir Coric has stock in Biohaven. Vladimir Coric has received intellectual property interests from a discovery or technology relating to health care.

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