M.Pneumoniae感染症に続発したと思われる中枢神経合併症の3例

Abstract

CNS complications of M. pneumoniae infections are not widely known yet. The relation between M. pneumoniae and CNS disease has been based mainly on clinical observations and serological data from serial serum samples. Isolations of this organism from CSF, blood and throat culture have been tried, but direct evidences of an etiologic relationship have been very few.In this paper, we reported three patients complicated with meningitis (case 2) and meningoencephalitis (case 1 & 3) who had respiratory tract infections diagnosed on the basis of clinical symptomes and serological findings of M. pneumoniae infection.Although nourologic symptomes have been improved, in two cases with meningoencephalitis, abnormal findings of EEG were respectively noticed about one and three months after onset. In one case (case 1), focal spike and wave were recognized in the left temporal area with a natural sleep activated EEG. In another case (case 3), 3-4c/s atypical spike and wave complex were recognized dominantly over the left hemisphere with a natural sleep activated EEG. These abnormal EEG findings have persisted for months or longer period. Accordingly, a long term follow-up by EEG should be required for these cases. R. J. Lerer stated that 21% of CNS complications of M. pneumoniae infections had no antecedent respiratory symptomes.This suggests that culture of M. pneumoniae and the serological tests for those cases of aseptic meningitis and meningoencephalitis, the etiology of which is unknown, should be carried out.