# Disseminated Ureaplasma urealyticum Infection and Hyperammonemic Encephalopathy in a Patient With Activated PI3K Delta Syndrome 2

## TL;DR

A young woman with a rare immune syndrome developed a Ureaplasma infection leading to brain-affecting high ammonia levels, a condition usually seen in transplant patients.

## Contribution

This case report expands the understanding of Ureaplasma-associated hyperammonemia beyond transplant recipients.

## Key findings

- Disseminated Ureaplasma urealyticum infection caused hyperammonemic encephalopathy in a non-transplant patient.
- The patient had activated PI3K delta syndrome 2, a rare primary immunodeficiency.
- Literature review suggests Ureaplasma-associated hyperammonemia can occur in non-transplant individuals.

## Abstract

Hyperammonemia syndrome (HS) from Ureaplasma infection is typically reported in posttransplant recipients, particularly lung transplant. We describe a young woman with activated PI3K delta syndrome 2 who presented with HS from disseminated Ureaplasma urealyticum infection with septic arthritis. We also performed a literature review of Ureaplasma-associated HS in nontransplant patients.