Trip Answers

Question answered:01/12/06 Warning! this question is over two years old.

Unfortunately, we cannot answer this question.

 

We searched the NLH Library ,TRIP and Medline databases but found no guidelines or studies reporting the incidence of myositis secondary to mycoplasma.

 

However, an e-Medicine article on pneumococcal infection notes:

 

“Myositis and brain and epidural abscesses occasionally have been reported.” [1]

 

A second e-Medicine article, one on mycoplasma infections states:

 

“Neurologic complications occur in approximately 1 per 1000 cases and usually are reversible; however, the mortality rate in patients with neurologic complications is higher than the rate in other patients. Recent reports suggest that CNS involvement is a common site in addition to the respiratory system, and may occur in up to 7% of patients hospitalized with M pneumoniae” [2].

 

Medline also contains references to a single case report and a review. The Medline abstracts to these references read:

 

“Respiratory tract infections with mycoplasma can cause severe infiltrating pneumonia (with pleuritis), associated with marked inflammatory reactions (maximal E.S.R., high leucocytosis with shift to the left and marked alpha 2-proteinaemia). Serial measurements of cold-agglutinin titres as well as complement-fixation reaction to Mycoplasma pneumoniae will confirm the diagnosis. Atypical forms of pneumonia can also be documented in that they respond only to erythromycin and extrapulmonary complications accompany the disease, giving them a protean character. In two such patients there was the clinical picture of pneumonia with high fever and marked inflammatory reaction, associated with anicteric hepatitis. In one there was also thoracic lymphadenitis, myositis and rash, in the other a meta- and post-infectious polyarthritis.” [3]

 

“Mycoplasma pneumonia infection can be associated with neurological manifestations such as meningoencephalitis, cerebellitis, aseptic meningoitis, polyradiculopathy, transverse myelitis, cranial nerve palsies and myositis. We report a case of a white female 11 years, 2 months old child, who presented with a 3 day history of pain in the left leg. The electromyograpy showed pathological signs. We found a serological titer of IgM antibodies for Mycoplasma pneumoniae. By treatment with erythromycin the complaints improved quickly. CONCLUSION: A myositis can be caused with an infection with Mycoplasma pneumoniae. The differential diagnosis is essential.” [4]

 

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References
1. Sinave C. Pneumococaal infections. e-Medicine. March 2004. (http://www.emedicine.com/med/topic1848.htm).
2. Chaterjee A. Mycoplasma infections. e-Medicine. July 2006. (http://www.emedicine.com/ped/topic1524.htm).
3. Hennemann HH, Gansser R. [Severe forms of mycoplasma pneumonia (author's transl)]. Dtsch Med Wochenschr. 1982 Jan 22;107(3):92-6. (http://www.hubmed.org/display.cgi?uids=7056163).
4. Brunner J and Jost W.  [Myositis caused by a mycoplasma infection]. Klin Padiatr. 2000 May-Jun;212(3):129-30. (http://www.hubmed.org/display.cgi?uids=10916786).

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