Mycoplasma pneumoniae central nervous system infections.

PURPOSE OF REVIEW: Mycoplasma pneumoniae is associated with a wide range of central nervous system diseases, most importantly with childhood encephalitis. This review summarizes and discusses recent findings in the field of M. pneumoniae central nervous system infections in context with previously published findings, with reference to clinical spectrum, pathogenesis, diagnosis, and treatment.

RECENT FINDINGS: Further insight into the pathogenesis has been provided by studies on cytokine production and autoantibody formation. Some new manifestations have been described (e.g. Kluver-Bucy syndrome, intracranial hypertension). Anecdotal descriptions on the association of M. pneumoniae with uncommon neurologic diseases remain to be confirmed by additional reports, however, especially when aetiologic diagnosis relied exclusively on serology. New knowledge on treatment options targeting the immune system has been provided by isolated reports. Recent diagnostic advances refer to general methods (polymerase chain reaction, serology), without specific reference to neurologic disease.

SUMMARY: M. pneumoniae must be considered as causative agent of various neurologic diseases. The recent literature shows, however, that the clinical spectrum of M. pneumoniae central nervous system disease is still not well defined. In addition, the main future challenges are the investigation of the pathogenesis of M. pneumoniae central nervous system disease and the establishment of therapeutic approaches.