Zusammenfassung
Wir berichten über einen 12-jährigen Patienten mit Otitis media, passager deutlich eingeschränkter Vigilanz und Herzrhythmusstörungen, die auf eine Infektion durch Mycoplasma pneumoniae zurückzuführen sind. IgM-Antikörper im Serum gegen Mycoplasma pneumoniae waren signifikant erhöht, während Mycoplasma pneumoniae im Liquor nicht nachgewiesen werden konnte. Innerhalb weniger Tage hatte sich der Patient vollständig erholt.
Bemerkenswert ist im vorliegenden Fall das gleichzeitige Auftreten einer Enzephalitis und Myokarditis. Der fehlende Nachweis von Mycoplasma-pneumoniae-DNA im Liquor und die nur gering entzündlich veränderten Parameter im Liquor sprechen für eine Begleitenzephalitis im Rahmen der Mycoplasma-pneumoniae-Infektion, möglicherweise durch einen Autoimmunprozess.
Abstract
A 12-year-old boy presented with coma and cardiac arrhytmia after inital symptoms of a flu-like febrile infection and otitis media. Titers against mycoplasma pneumoniae were significantly increased in serum. Detection of mycoplasma pneumoniae could not be found by PCR in a liquor sample. The patient had a rapid and complete recovery over several days. This case report demonstrates a well documented course of an mycoplasma pneumoniae infection resulting in both coma and cardiac arrhytmia. It furthermore exemplifies that coma can result from acute infection with mycoplasma pneumoniae in the absence of an inflammatory cerebrospinal fluid response.
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Koch, M., Zabel, L.T., Bosk, A. et al. Meningoenzephalitis und Myokarditis durch seltene Erreger. Monatsschr Kinderheilkd 151, 745–748 (2003). https://doi.org/10.1007/s00112-002-0470-7
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DOI: https://doi.org/10.1007/s00112-002-0470-7