TRANSVERSE MYELITIS ASSOCIATED WITH MYCOPLASMA-PNEUMONIAE INFECTION

A 14-year-old boy developed acute transverse myelitis with severe abdo minal pain, bladder dysfunction, weakness, and sensory loss of the low er extremities. Magnetic resonance imaging revealed a segmental expand ed central edema affecting parts of the spinal cord, including the cau dal medulla oblongata. Antibody response to Mycoplasma pneumoniae was negative in microparticle agglutination assays (1:40 in the acute seru m and 1:160 in the convalescent serum) and complement fixation tests ( 1:20 and 1:10). However, analysis of acute-phase serum revealed a spec ific IgA and IgG response but no IgM response. Detection of M. pneumon iae in the cerebrospinal fluid by nested polymerase chain reaction and in nasopharyngeal aspirate by culture confirmed an M. pneumoniae infe ction. Treatment with doxycycline (100 mg daily) was started on the se cond day after admission to the hospital and continued for 14 days; th e patient recovered completely and was discharged 20 days after onset of the disease, with no signs of neurological deficits.