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CASE REPORT article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1393540

A Co-occurring Case of Severe Mycoplasma pneumoniae Pneumonia and Anti-IgLON5 Antibody-associated Encephalitis in a Pediatric Patient

Provisionally accepted
Zimao Ye Zimao Ye Yuequn Chen Yuequn Chen Xin Tian Xin Tian *
  • Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    This case report details the clinical course of a 16-year-old female student with Mycoplasma pneumoniae infection complicated by autoimmune encephalitis, spanning from February 6, 2022, to April 12, 2022, with a one-year follow-up. The patient presented with a two-week history of cough and fever, followed by altered consciousness and neuropsychiatric symptoms, including hyperactivity and incoherent speech. Despite normal brain MRI findings, cerebrospinal fluid (CSF) analysis confirmed Mycoplasma pneumoniae with titers of, and positive IgLON5 antibodies. Initial treatment included azithromycin, ceftriaxone, and acyclovir, followed by mechanical ventilation and ECMO due to respiratory failure. The antibiotic regimen was switched to intravenous omadacycline based on genetic testing results.Autoimmune encephalitis was managed with intravenous methylprednisolone, intravenous immunoglobulin (IVIG), and plasma exchange. The patient's condition improved, and she was discharged on March 12, 2022, with normal cognitive and behavioral functions. However, she was readmitted one month later due to cognitive decline and sleep disturbances, with a Mini-Mental State Examination (MMSE) score of 20/30 and a modified Rankin Scale (mRS) score of 3. At the one-year follow-up, her MMSE score had improved to 28/30, and her mRS score was 1. This case underscores the importance of comprehensive diagnostic approaches and personalized treatment strategies in managing complex cases of mycoplasma-related infections and associated autoimmune conditions.

    Keywords: Mycoplasma pneumoniae pneumonia, Encephalitis, Extracorporeal Membrane Oxygenation, Azithromycin, Pediatric Neuroimmunology

    Received: 29 Feb 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Ye, Chen and Tian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xin Tian, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang Province, China

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