Scientific letter
Anisocoria and optic neuritis associated with Mycoplasma pneumoniae infection
Anisocoria y neuritis óptica en infección por Mycoplasma pneumoniae
Read
273
Timeswas read the article
71
Total PDF
202
Total HTML
Share statistics
array:23 [ "pii" => "S2529993X23000023" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2023.01.001" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "2651" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:312-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S0213005X22001835" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2022.08.010" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "2651" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:312-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Anisocoria y neuritis óptica en infección por <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "312" "paginaFinal" => "314" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Anisocoria and optic neuritis associated with <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> infection" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3505 "Ancho" => 2925 "Tamanyo" => 466117 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Radiografía de tórax (imagen superior) y resonancia magnética craneal del paciente (imagen inferior).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Diego Gayoso-Cantero, Claudia Sarró-Fuentes, Manuel Barón-Rubio, Juan Emilio Losa-García" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Diego" "apellidos" => "Gayoso-Cantero" ] 1 => array:2 [ "nombre" => "Claudia" "apellidos" => "Sarró-Fuentes" ] 2 => array:2 [ "nombre" => "Manuel" "apellidos" => "Barón-Rubio" ] 3 => array:2 [ "nombre" => "Juan Emilio" "apellidos" => "Losa-García" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X23000023" "doi" => "10.1016/j.eimce.2023.01.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X23000023?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X22001835?idApp=UINPBA00004N" "url" => "/0213005X/0000004100000005/v1_202305031128/S0213005X22001835/v1_202305031128/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2529993X23000266" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2022.08.013" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "2652" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:314-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Infective endocarditis caused by <span class="elsevierStyleItalic">Streptococcus cristatus</span>" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "314" "paginaFinal" => "315" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Endocarditis infecciosa causada por <span class="elsevierStyleItalic">Streptococcus cristatus</span>" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 694 "Ancho" => 1676 "Tamanyo" => 123781 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Joint CT and PET-CT study performed following endocarditis protocol after inconclusive result by transoesophageal echocardiogram by administration of intravenous contrast and 18-FDG, with imaging from the cervical region up to and including the pelvis. Hypodense lesions of triangular morphology and new appearance in the lower pole of the spleen and interpolar region of the left kidney, compatible with small infarcts (yellow circles). Focal increase in metabolic activity (yellow line) on the prosthetic aortic valve annulus's anterior region makes it impossible to rule out endocarditis without significant morphological findings.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Domingo Fernández Vecilla, José Luis Díaz de Tuesta del Arco" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Domingo" "apellidos" => "Fernández Vecilla" ] 1 => array:2 [ "nombre" => "José Luis" "apellidos" => "Díaz de Tuesta del Arco" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X23000266?idApp=UINPBA00004N" "url" => "/2529993X/0000004100000005/v2_202311091702/S2529993X23000266/v2_202311091702/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2529993X23000254" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2022.08.012" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "2647" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2023;41:311-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Molecular characterization of <span class="elsevierStyleItalic">Staphylococcus aureus</span> causing menstrual toxic shock syndrome in a young woman" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "311" "paginaFinal" => "312" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Caracterización molecular de <span class="elsevierStyleItalic">Staphylococccus aureus,</span> agente causal del síndrome del shock tóxico menstrual en una mujer joven" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Font-Font, Alba Bellés-Bellés, Rosa Fernández-Fernández, Carmen Torres" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Maria" "apellidos" => "Font-Font" ] 1 => array:2 [ "nombre" => "Alba" "apellidos" => "Bellés-Bellés" ] 2 => array:2 [ "nombre" => "Rosa" "apellidos" => "Fernández-Fernández" ] 3 => array:2 [ "nombre" => "Carmen" "apellidos" => "Torres" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X23000254?idApp=UINPBA00004N" "url" => "/2529993X/0000004100000005/v2_202311091702/S2529993X23000254/v2_202311091702/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Anisocoria and optic neuritis associated with <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> infection" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "312" "paginaFinal" => "314" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Diego Gayoso-Cantero, Claudia Sarró-Fuentes, Manuel Barón-Rubio, Juan Emilio Losa-García" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Diego" "apellidos" => "Gayoso-Cantero" "email" => array:1 [ 0 => "gayosocan@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Claudia" "apellidos" => "Sarró-Fuentes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Manuel" "apellidos" => "Barón-Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Juan Emilio" "apellidos" => "Losa-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neurología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Anisocoria y neuritis óptica en infección por <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3505 "Ancho" => 2925 "Tamanyo" => 466117 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray (upper image) and brain MRI of the patient (lower image).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Although the most common clinical form of infection by <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> (<span class="elsevierStyleItalic">M. pneumoniae</span>) is respiratory, this microorganism can cause extrapulmonary manifestations, the most serious of which is neurological<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. We report here a case with anisocoria and optic neuritis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">This was a 32-year-old man with no previous medical history who had a two-week history of productive cough, dyspnoea, low-grade fever, nasal congestion and left hearing loss. Chest X-ray (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, upper) revealed an infiltrate in the right upper lobe. <span class="elsevierStyleItalic">Legionella pneumophila</span> and pneumococcal urinary antigen tests were negative and treatment was started with amoxicillin/clavulanic acid 875/125<span class="elsevierStyleHsp" style=""></span>mg/8<span class="elsevierStyleHsp" style=""></span>h.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Two days later, the patient had not improved and attended Accident & Emergency; he had tachypnoea, with a baseline saturation of 88%, which rose to 95% with nasal cannula at 2 lpm, HR 46 bpm, blood pressure 124/68 and rhonchi in the upper right lung field.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Tests revealed leucocytosis with neutrophilia, coagulopathy (INR 1.3) and C-reactive protein of 103<span class="elsevierStyleHsp" style=""></span>mg/l, and a repeat chest X-ray showed no changes. Treatment was escalated to ceftriaxone 2<span class="elsevierStyleHsp" style=""></span>g/24<span class="elsevierStyleHsp" style=""></span>h with levofloxacin 500<span class="elsevierStyleHsp" style=""></span>mg/24<span class="elsevierStyleHsp" style=""></span>h and the patient was admitted to internal medicine.</p><p id="par0025" class="elsevierStylePara elsevierViewall">On day three of admission he developed anisocoria, with greater mydriasis in his left eye. CT scan of the brain showed no acute intracranial findings. Pilocarpine eye drop test showed involvement of the left third cranial nerve.</p><p id="par0030" class="elsevierStylePara elsevierViewall">CT angiogram of the head ruled out vascular injury and MRI ruled out cavernous sinus pathology, showing right maxillary sinusitis and left ethmoid sinus retention cyst (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, lower). After 24<span class="elsevierStyleHsp" style=""></span>h, the anisocoria resolved spontaneously.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Multiplex PCR was carried out on nasopharyngeal exudate and sputum, which was positive for <span class="elsevierStyleItalic">M. pneumoniae</span> and negative for coronavirus, MERS-CoV, rhinovirus/enterovirus, influenza and parainfluenza virus, metapneumovirus, adenovirus and respiratory syncytial virus. Serum was also positive for <span class="elsevierStyleItalic">M. pneumoniae</span> IgM. HIV, syphilis and hepatotropic virus serologies were all negative. Azithromycin 500<span class="elsevierStyleHsp" style=""></span>mg/24<span class="elsevierStyleHsp" style=""></span>h for seven days was prescribed.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Four days later, the patient consulted once more due to loss of visual acuity in his left eye. Visual field testing revealed a diffuse loss of sensitivity with a superior altitudinal visual field defect in the left eye and visual acuity of 0.5. Lumbar puncture ruled out infection of the central nervous system. As parainfectious retrobulbar optic neuritis was suspected, he was started on corticosteroid therapy and made a full recovery.</p><p id="par0045" class="elsevierStylePara elsevierViewall">At subsequent check-ups, the electroencephalogram, cervical spine magnetic resonance imaging and brain magnetic resonance angiography were normal, and the follow-up lumbar puncture showed no oligoclonal bands. Blood aquaporin 4 antibodies and myelin oligodendrocyte glycoprotein antibodies were negative, but he had a mild sustained IgG2 deficiency. After seven weeks, he continued to be IgM positive, with IgG seroconversion against <span class="elsevierStyleItalic">M. pneumoniae</span> (signal 1.41).</p><p id="par0050" class="elsevierStylePara elsevierViewall">The incidence of central nervous system complications due to <span class="elsevierStyleItalic">Mycoplasma</span> spp. has not been established; it ranges from 1% to 7% in hospitalised patients, with the mortality rate as high as 10%<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. Over half of cases are found in patients between 6 and 21 years of age<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>, but it also occurs in adults. Parainfectious neuritis usually occurs bilaterally and is more active in children<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>, and up to 20% may have no prior respiratory infection<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>.</p><p id="par0055" class="elsevierStylePara elsevierViewall">There are several mechanisms involved in the neurological complications, none of which is exclusive. There may be direct cell damage following haematogenous spread of the microorganism reaching the central nervous system. When the bacteria damages cells, the innate immune response is activated, attracting different cytokines such as IL 18, which activates helper T cells 1 and 2, or IL 8, which attracts neutrophils. It can be mediated by immune complexes due to antigenic elements, which bind to the patient's macrophages and monocytes, initiating immune reactions due to the antigenic similarities between <span class="elsevierStyleItalic">M. pneumoniae</span> and brain parenchyma antigens<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. Vascular damage is also possible<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The incidence of <span class="elsevierStyleItalic">Mycoplasma</span> spp. infections is increasing in patients with hypogammaglobulinaemia, which indicates compromise of humoral immunity in the pathogenesis of these cases<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>. Antibodies inhibit the growth of <span class="elsevierStyleItalic">M. pneumoniae in vitro</span>, preventing proliferation on the surface of colonised mucosa<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>, without affecting neutrophil opsonisation<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Our patient had optic neuritis as a rare complication in <span class="elsevierStyleItalic">M. pneumoniae</span> infections. It is likely that partial IgG2 deficiency facilitated infection and cell mimicry led to the neurological symptoms. We need to be aware of the association between hypogammaglobulinaemia and the risk of <span class="elsevierStyleItalic">M. pneumoniae</span> infection, as these patients can suffer from more severe and prolonged illnesses and develop more complications<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3505 "Ancho" => 2925 "Tamanyo" => 466117 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray (upper image) and brain MRI of the patient (lower image).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathogenesis and treatment of neurologic diseases associated with Mycoplasma pneumoniae infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. D’Alonzo" 1 => "E. Mencaroni" 2 => "L. Di Genova" 3 => "D. Laino" 4 => "N. Principi" 5 => "S. Esposito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fmicb.2018.02751" "Revista" => array:5 [ "tituloSerie" => "Front Microbiol." "fecha" => "2018" "volumen" => "9" "paginaInicial" => "2751" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30515139" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycoplasma pneumoniae and central nervous system complications: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Guleria" 1 => "N. Nisar" 2 => "T.C. Chawla" 3 => "N.R. Biswas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.lab.2005.04.006" "Revista" => array:6 [ "tituloSerie" => "J Lab Clin Med." "fecha" => "2005" "volumen" => "146" "paginaInicial" => "55" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16099235" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parainfectious optic neuritis: manifestations in children vs adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Rappoport" 1 => "N. Goldenberg-Cohen" 2 => "J. Luckman" 3 => "H. Leiba" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/WNO.0000000000000113" "Revista" => array:6 [ "tituloSerie" => "J Neuroophthalmol." "fecha" => "2014" "volumen" => "34" "paginaInicial" => "122" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24667772" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated optic neuritis associated with Mycoplasma pneumoniae infection: report of two cases and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.Y. Choi" 1 => "Y.J. Choi" 2 => "J.H. Choi" 3 => "K.D. Choi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10072-017-2922-9" "Revista" => array:6 [ "tituloSerie" => "Neurol Sci." "fecha" => "2017" "volumen" => "38" "paginaInicial" => "1323" "paginaFinal" => "1327" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28321515" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Central nervous system manifestations of Mycoplasma pneumoniae infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Tsiodras" 1 => "I. Kelesidis" 2 => "T. Kelesidis" 3 => "E. Stamboulis" 4 => "H. Giamarellou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jinf.2005.07.005" "Revista" => array:6 [ "tituloSerie" => "J Infect." "fecha" => "2005" "volumen" => "51" "paginaInicial" => "343" "paginaFinal" => "354" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16181677" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Classification of extrapulmonary manifestations due to Mycoplasma pneumoniae infection on the basis of possible pathogenesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Narita" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fmicb.2016.00023" "Revista" => array:5 [ "tituloSerie" => "Front Microbiol." "fecha" => "2016" "volumen" => "7" "paginaInicial" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26858701" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased susceptibility to Mycoplasma infection in patients with hypogammaglobulinemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.M. Roifman" 1 => "C.P. Rao" 2 => "H.M. Lederman" 3 => "S. Lavi" 4 => "P. Quinn" 5 => "E.W. Gelfand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0002-9343(86)90812-0" "Revista" => array:6 [ "tituloSerie" => "Am J Med." "fecha" => "1986" "volumen" => "80" "paginaInicial" => "590" "paginaFinal" => "594" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3963038" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unique susceptibility of patients with antibody deficiency to mycoplasma infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E.W. Gelfand" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Infect Dis." "fecha" => "1993" "volumen" => "17" "numero" => "Suppl 1" "paginaInicial" => "S250" "paginaFinal" => "3" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8399924" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Critical dependence on antibody for defence against mycoplasmas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.D. Webster" 1 => "P.M. Furr" 2 => "N.C. Hughes-Jones" 3 => "B.D. Gorick" 4 => "D. Taylor-Robinson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Immunol." "fecha" => "1988" "volumen" => "71" "paginaInicial" => "383" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3383447" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycoplasma pneumoniae infections in patients with immunodeficiency syndromes: report of four cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.M. Foy" 1 => "H. Ochs" 2 => "S.D. Davis" 3 => "G.E. Kenny" 4 => "R.R. Luce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/infdis/127.4.388" "Revista" => array:6 [ "tituloSerie" => "J Infect Dis." "fecha" => "1973" "volumen" => "127" "paginaInicial" => "388" "paginaFinal" => "393" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4694545" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000004100000005/v2_202311091702/S2529993X23000023/v2_202311091702/en/main.assets" "Apartado" => array:4 [ "identificador" => "63562" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000004100000005/v2_202311091702/S2529993X23000023/v2_202311091702/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X23000023?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 0 | 3 |
| 2024 October | 27 | 4 | 31 |
| 2024 September | 24 | 11 | 35 |
| 2024 August | 31 | 18 | 49 |
| 2024 July | 17 | 0 | 17 |
| 2024 June | 9 | 5 | 14 |
| 2024 May | 13 | 2 | 15 |
| 2024 April | 25 | 2 | 27 |
| 2024 March | 16 | 3 | 19 |
| 2024 February | 3 | 3 | 6 |
| 2024 January | 8 | 6 | 14 |
| 2023 December | 14 | 11 | 25 |
| 2023 November | 11 | 6 | 17 |
| 2023 May | 1 | 0 | 1 |
Show all
