Basal Ganglia Involvement in Pediatric Mycoplasma pneumoniae Meningoencephalitis: Two Cases and a Literature Review.
Level 4 - case-series / case-control
Case reports and descriptive literature review of case reports
PubMed 41133656 · doi:10.3390/epidemiologia6040062
What was done
The authors describe two pediatric cases (a 12-year-old male and a 14-year-old female) presenting with acute meningoencephalitis syndrome, evaluated with brain MRI, cerebrospinal fluid analysis, serum serology, and pharyngeal swab PCR. A literature search across PubMed, Scopus, and Web of Science was also conducted to identify published pediatric cases of Mycoplasma pneumoniae meningoencephalitis detailing MRI abnormalities.
What was found
Both patients exhibited marked cerebrospinal fluid mononuclear pleocytosis, bilateral basal ganglia lesions on MRI, and serologically confirmed M. pneumoniae infection (one patient also tested positive via pharyngeal PCR). Both patients achieved complete clinical recovery and total regression of MRI lesions following corticosteroid therapy. The literature search identified a total of 21 previously reported pediatric cases with basal ganglia involvement.
Why it matters
Bilateral basal ganglia lesions and prominent CSF pleocytosis can serve as neuroimaging and clinical clues for M. pneumoniae meningoencephalitis in older children, particularly when respiratory manifestations are mild or missing.
Limits
The evidence is limited to two individual case reports and a small narrative compilation of 21 historical cases. Observational case reporting prevents establishing a definitive causal link between corticosteroid treatment and recovery, and diagnostic details (such as direct CNS pathogen detection via CSF PCR) were not reported in the abstract.
Cited by
- supports Mycoplasma infections can localize to and affect the basal ganglia.