Pneumonia Infection

Mycoplasma pneumonia is a ubiquitous respiratory bacterium that causes community acquired pneumonia and other respiratory disease. Neurological sequelae occur in up to 7% of patients with M pneumonia infections and include meningoencephalitis, inflammatory neuropathies and transverse myelitis. Different immune mechanisms may account for this heterogeneity. It appears that Mycoplasma Associated Meningitis (MAM) either occurs early, possibly due to bacterial invasion of the CNS or late secondary to a suspected post-infectious immune phenomenon. We present a case of early M pneumonia meningitis and myelitis that failed to show clinical improvement with directed antimicrobial therapy but responded to corticosteroids. A 24 year old Aboriginal male presented to a rural hospital in New South Wales, Australia with 24 hours of fever (39.3°C), frontal headache, neck pain, vomiting and photophobia. The patient denied recent travel or intravenous drug use and was not immunosuppressed. He had an upper respiratory tract infection four days prior to presentation. Despite treatment with intravenous ceftriaxone (1gm daily) and oral doxycycline (100 mg daily) the high fevers and meningitic symptoms persisted. After five days, intravenous benzylpenicillin, acyclovir and vancomycin were added but without effect.

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Last date updated on January, 2025