Atypical Cause of Autoimmune Encephalitis: The Role of Mycoplasma pneumoniae in Status Epilepticus

TL;DR

This paper reports a rare case of Mycoplasma pneumoniae causing autoimmune encephalitis in an adult, emphasizing the need for better recognition and treatment strategies.

Contribution

The paper presents a novel case of Mycoplasma-induced seronegative autoimmune encephalitis in an adult, highlighting diagnostic challenges and clinical implications.

Findings

A 37-year-old man with Mycoplasma-induced autoimmune encephalitis required intensive immunosuppressive and antimicrobial therapy.

The patient recovered to his baseline after a four-month hospital stay, with no new neurological deficits.

The case underscores the importance of early recognition of Mycoplasma-associated autoimmune encephalitis for improved outcomes.

Abstract

Autoimmune encephalitis is a group of conditions characterized by a rapid onset of neurological symptoms, such as seizures and cognitive impairment, along with psychiatric disturbances such as behavioral changes and psychosis. Viral infections are common, well-documented triggers, but the role of bacterial pathogens, particularly Mycoplasma pneumoniae, remains poorly understood. Mycoplasma pneumoniae has been implicated in autoimmune encephalitis previously, but reported cases are rare. This report presents a case of Mycoplasma-induced seronegative autoimmune encephalitis in a previously healthy adult, highlighting the diagnostic challenges and the need for early recognition. The patient, a 37-year-old man with a past medical history of asthma, presented with encephalopathy and confusion following a fall in the shower a few hours previously. He then experienced refractory seizures necessitating intensive immunosuppressive and antimicrobial therapy. After a four-month hospital stay, primarily in the ICU, the patient returned to his baseline and was discharged home after four days without experiencing any new neurological deficits or seizures. Given the potential for delayed diagnosis and severe neurological complications, increased clinical awareness and further research are needed to improve diagnostic and therapeutic strategies for Mycoplasma-associated autoimmune encephalitis.

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