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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Neuro-ophthalmological manifestations as complication of an infection with Mycop...
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Vol. 95. Issue 5.
Pages 254-258 (May 2020)
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Vol. 95. Issue 5.
Pages 254-258 (May 2020)
Short communication
Neuro-ophthalmological manifestations as complication of an infection with Mycoplasma pneumoniae and subsequent development of disseminated acute encephalitis
Manifestaciones neuroftalmológicas como complicación de una infección por Mycoplasma pneumoniae y desarrollo posterior de una encefalitis aguda diseminada
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M. Molero-Senosiain
Corresponding author
merce.molero@gmail.com

Corresponding author.
, B. Domingo-Gordo, C. Fernández Cabrera, E. Hernández-García, R. Gómez de Liaño
Departamento de Neuroftalmología, Hospital Clínico San Carlos, Madrid, Spain
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Table 1. Comparative summary of clinic cases.
Abstract

The purpose of this article is to describe two pediatric neuro-ophthalmological clinical cases caused by a systemic infection due to Mycoplasma pneumoniae (M. pneumoniae). The cases are two girls aged 14 and 12 seen in the Emergency Department: The first one had internuclear ophthalmoplegia and second with loss of vision and headache. They had no other neurological foci. Magnetic resonance imaging showed hyperintense plaques in both, suggestive of a demyelinating disease. One month later, the neuro-ophthalmological symptoms resolved, with normal follow-up magnetic resonance imagings. The diagnosis was acute disseminated encephalitis secondary to M. pneumoniae. The diagnosis was made using PCR (gold standard) and/or IgM in serology. It is important to think about this possible etiology in cases of suggestive demyelinating disease. There is controversy about the role of antibiotics and on whether corticosteroids are contemplated. In conclusion, M. pneumoniae must be a differential diagnosis in acute neuro-ophthalmological disorders in children.

Keywords:
Mycoplasma pneumoniae
Acute disseminated encephalomyelitis (ADEM)
Bilateral internuclear ophthalmoplegia (WEBINO)
Neuritis
Magnetic resonance imaging
Resumen

El objetivo es describir dos cuadros clínicos neuroftalmológicos en niños por infección sistémica por Mycoplasma pneumoniae (M. pneumoniae). Se presentan los casos de dos niñas de 14 y 12 años que acudieron a urgencias: la primera con oftalmoplejía internuclear y la segunda con pérdida de visión y cefalea. No presentaban otra focalidad neurológica. En la imagen de resonancia magnética se evidenciaron placas hiperintensas en ambas, sugerentes de cuadro desmielinizante. Al mes, los síntomas neuroftalmológicos se resolvieron y las resonancias magnéticas de control fueron normales. El diagnóstico fue encefalitis diseminada aguda secundaria a M. pneumoniae. El diagnóstico se hace por PCR (gold standard) y/o IgM en serología. Es importante pensar en esta posible etiología ante casos sugerentes de enfermedad desmielinizante. Existe controversia sobre el papel de los antibióticos y si se contemplan los corticoides. Como conclusión, M. pneumoniae debe ser diagnóstico diferencial en afectaciones neuroftalmológicas agudas en niños.

Palabras clave:
Mycoplasma pneumoniae
Encefalomielitis diseminada aguda (ADEM)
Oftalmoplejía internuclear bilateral (WEBINO)
Neuritis
Resonancia magnética

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