Mycoplasma pneumoniae: A cause of coma in the absence of meningoencephalitis

Mycoplasma pneumoniae encephalitis is a recognized cause of reversible coma in children. As an etiology of infectious encephalitis, it yields a relati vely poorer prognosis than most other causes of infectious encephalopathies , Encephalitis is generally diagnosed by a constellation of clinical sympto ms and confirmed by a cerebrospinal fluid (CSF) examination revealing cell pleocytosis and elevated protein. That Mycoplasma pneumoniae encephalopathy can occur in the presence of a normal CSF examination is less well appreci ated. The authors report two children who presented with coma and normal CS F findings in whom a diagnosis of acute Mycoplasma pneumoniae infection was made. The tno children both had rapid and complete recovery over several d ays. These cases exemplify that coma can result from acute infection with M ycoplasma pneumoniae in the absence of an inflammatory CSP response and tha t a normal CSF may herald a more favorable prognosis. (C) 1999 by Elsevier Science Inc. All rights reserved.