Fernandez C V, Bortolussi R, Gordon K, Lee S H, Gatien J G, Shahdrabadi M S
Izaak Walton Killam Hospital, Halifax, Nova Scotia.
J Child Neurol. 1993 Jan;8(1):27-31. doi: 10.1177/088307389300800104.
We describe two children who had central nervous system complications, encephalitis and meningoencephalitis, temporally associated with Mycoplasma pneumoniae. M pneumoniae was identified as the cause of the illnesses on the basis of at least a fourfold increase in complement fixation antibody titers. Despite extensive viral and bacterial investigation, no evidence of any other pathogen was found. Two strategies were used to determine whether M pneumoniae was directly invasive: (1) by examining cerebrospinal fluid using a M pneumoniae-specific DNA probe and (2) by determining whether complement-fixating antibody to M pneumoniae was produced locally through comparison of the cerebrospinal fluid/serum ratio of M pneumoniae antibody to the cerebrospinal fluid/serum ratio of immunoglobulin M. Both assessments were negative. M pneumoniae did not appear to directly invade the central nervous system in these two patients. We conclude that the direct invasion of the cerebrospinal fluid is not necessary in the pathogenesis of M pneumoniae-induced neurologic disease.
我们描述了两名患有中枢神经系统并发症（脑炎和脑膜脑炎）的儿童，这些并发症在时间上与肺炎支原体相关。根据补体结合抗体滴度至少升高四倍，确定肺炎支原体为病因。尽管进行了广泛的病毒和细菌检测，但未发现任何其他病原体的证据。采用了两种策略来确定肺炎支原体是否直接侵入：（1）使用肺炎支原体特异性DNA探针检测脑脊液；（2）通过比较肺炎支原体抗体的脑脊液/血清比值与免疫球蛋白M的脑脊液/血清比值，确定肺炎支原体的补体结合抗体是否在局部产生。两项评估均为阴性。在这两名患者中，肺炎支原体似乎并未直接侵入中枢神经系统。我们得出结论，在肺炎支原体所致神经系统疾病的发病机制中，脑脊液的直接侵入并非必要条件。
