[P3-96] The Ten-Year Experience of Severe Mycoplasma Pneumoniae Associated Encephalitis in Childhood in a Tertiary Center Pediatric Intensive Care Unit
[Background]
Mycoplasma pneumoniae associated encephalitis accounts for 5~10% of childhood encephalitis in Europe and North America. Few studies illustrated the critical condition of this acute encephalitis. We studied the severe presentations of mycoplasma encephalitis in the recent 10 years in the pediatric intensive care unit (PICU) at Kaohsiung Chang Gung Memorial Hospital.
[Methods]
We retrospectively reviewed chart and collected clinical data in patients diagnosed as severe mycoplasma encephalitis from Jan 2005 to May 2016. Case definition included confirmed, probable and possible cases. The patients were divided into good and poor outcome based on neurologic sequelae. We analyzed the predictors lead to poor outcome.
[Results]
15 patients were enrolled, 14 of them were probable cases. Six required ventilation during acute phase. Eight patients (50%) had seizure during acute phase, and five of them (62.5%) presented as status epilepticus. Three of these five status epilepticus developed febrile infection-related epilepsy syndrome (FIRES). One died from nosocomial infection. Five had abnormal cranial MRI (5/15, 33%). None of all could be detected Mycoplasma DNA in the CSF.
Five patients belonged to poor outcome, including epilepsy (n = 3), unstable gait (n=1) , and death (n=1). The predictors for poor neurologic outcome included status epilepticus, consciousness disturbance, and leukopenia.
[Conclusions]
The lack of detectable M. pneumonia DNA in CSF analysis indicated that mycoplasma encephalitis is immune-mediated pathogenesis. Immunotherapy is needed in the severe cases. Our study concluded that status epilepticus, consciousness disturbance, and leukopenia can be
the predictors for poor neurologic outcome in severe mycoplasma encephalitis.
Mycoplasma pneumoniae associated encephalitis accounts for 5~10% of childhood encephalitis in Europe and North America. Few studies illustrated the critical condition of this acute encephalitis. We studied the severe presentations of mycoplasma encephalitis in the recent 10 years in the pediatric intensive care unit (PICU) at Kaohsiung Chang Gung Memorial Hospital.
[Methods]
We retrospectively reviewed chart and collected clinical data in patients diagnosed as severe mycoplasma encephalitis from Jan 2005 to May 2016. Case definition included confirmed, probable and possible cases. The patients were divided into good and poor outcome based on neurologic sequelae. We analyzed the predictors lead to poor outcome.
[Results]
15 patients were enrolled, 14 of them were probable cases. Six required ventilation during acute phase. Eight patients (50%) had seizure during acute phase, and five of them (62.5%) presented as status epilepticus. Three of these five status epilepticus developed febrile infection-related epilepsy syndrome (FIRES). One died from nosocomial infection. Five had abnormal cranial MRI (5/15, 33%). None of all could be detected Mycoplasma DNA in the CSF.
Five patients belonged to poor outcome, including epilepsy (n = 3), unstable gait (n=1) , and death (n=1). The predictors for poor neurologic outcome included status epilepticus, consciousness disturbance, and leukopenia.
[Conclusions]
The lack of detectable M. pneumonia DNA in CSF analysis indicated that mycoplasma encephalitis is immune-mediated pathogenesis. Immunotherapy is needed in the severe cases. Our study concluded that status epilepticus, consciousness disturbance, and leukopenia can be
the predictors for poor neurologic outcome in severe mycoplasma encephalitis.