Stroke in Mycoplasma pneumoniae pneumonia: a clinical case

Submitted: 27 February 2023
Accepted: 24 March 2023
Published: 21 April 2023
Abstract Views: 231
PDF: 143
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


Mycoplasma pneumoniae (MP) cause more than 40% of community- acquired pneumonia. Sometimes extrapulmonary manifestations may occur: in particular, central nervous system (CNS) symptoms occur in 10% of hospitalizations for MP. A young woman was being admitted to our intensive care unit (ICU) for respiratory failure and suspected stroke, ten days after flu-like syndrome. The patient was already intubated, sedated, in controlled mechanical ventilation. At admission brain computed tomography (CT) was negative, chest CT showed bilateral pneumonia with interstitial thickening. After 36 hours, brain CT showed an extensive hypodense cortico-subcortical area with frontal-parietal-temporal left seat. The positivity of IgM for MP and PCR in nasopharynx led to the diagnosis of MP pneumonia complicated by stroke: 15 days after admission, a post-ischemic status was manifested by aphasia, dysphagia, right brachio-crural hemiplegia. In our paper we evaluated possible major neurological complications, up to stroke, in MP respiratory infection. We concluded that, although they are actually rare, neurological symptoms up to cerebral ischemia in young people with MP pneumonia, are to be considered.



PlumX Metrics


Download data is not yet available.


Koskiniemi M. CNS manifestations associated with Mycoplasma pneumoniae infections: summary of cases at the University of Helsinki and review. Clin Infect Dis 1993;17:S52-7. DOI:
Kolski H, Ford-Jones EL, Richardson S, et al. Etiology of acute childhood encephalitis at The Hospital for Sick Children, Toronto, 1994-1995. Clin Infect Dis 1998;26:398-409. DOI:
Parrot G.L., Kinjo T and Fujita J. A compendium for mycoplasma pneumonaie. Front Microbiol 2016;7:513. DOI:
Norisue Y, Tokuda Y, Koizumi M, et al . Phasic characteristics of inspiratory crackles of bacterial and atypical pneumonia. Postgrad Med J 2008;84:432–6. DOI:
Nambu A, Saito A, Araki T, et al. Chlamydia pneumoniae: comparison with findings of Mycoplasma pneumoniae and Streptococcus pneumoniae at thin-section CT. Radiology 2006;238:330–8. DOI:
Reittner P, Muller NL, Heyneman L, et al. Mycoplasma pneumoniae pneumonia: radiographic and high-resolution CT features in 28 patients. Am J Roentgenol 2000;174:37–41. DOI:
Miyashita N, Sugiu T, Kawai Y, et al. Radiographic features of Mycoplasma pneumoniae pneumonia: differential diagnosis and performance timing. BMC Med Imaging 2009;9:7 DOI:
Tsiodras S, Kelesidis I, Kelesidis T, et al. Central nervous system manifestations of Mycoplasma pneumoniae infections. J Infect 2005;51:343-54. DOI:
Palumbo E, Malorgio C, Nasca G, et al. Encefalite da mycoplasma pneumoniae in un bambino immunocompetente. Recenti Prog Med 2008;99:306-8.
Chiang CH, Huang CC, Chan WL, et al. Association between Mycoplasma pneumonia and increased risk of ischemic stroke: a nationwide study. Stroke 2011;42:2940–3. DOI:
Higuchi ML, Sambiase N, Palomino S, et al. Detection of Mycoplasma pneumoniae and Chlamydia pneumoniae in ruptured atherosclerotic plaques. Braz J Med Biol Res 2000;33:1023-6. DOI:
Lu Y-J, Chen T-H, Lin L-H, et al. Macrolide use shortens fever duration in Mycoplasma pneumoniae infection in children: a 2-year experience . J Microbiol Immunol Infect 2008;41:307-10.
Socan M, Ravnik I, Bencina D, et al. Neurological symptoms in patients whose cerebrospinal fluid is culture- and/or polymerase chain reaction-positive for Mycoplasma pneumoniae. Clin Infect Dis 2001;32:E31-5. DOI:
Padovan CS, Pfister HW, Bense S, et al. Detection of Mycoplasma pneumoniae DNA in cerebrospinal fluid of a patient with M. pneumoniae infection-“associated” stroke. J Clin Microbiol 2007;45:2726-30.
Bitnun A, Ford-Jones EL, Petric M, et al. Acute childhood encephalitis and Mycoplasma pneumoniae. Clin Infect Dis 2001;32:1674-84. DOI:
Perez C, Montes M. Cutaneous leukocytoclastic vasculitis and encephalitis associated with Mycoplasma pneumoniae infection. Arch Intern Med 2002;162:352-4. DOI:
Mirsky DM, Beslow LA, Amlie-Lefond C, et al. Pathways for neuroimaging of childhood stroke. Pediatr Neurol 2017;69:11-23. DOI:
Turc G, Calvet D, Guerin P, et al. Closure, anticoagulation, or antiplatelet therapy for cryptogenic stroke with patent foramen ovale: systematic review of randomized trials, sequential meta-analysis, and new insights from the CLOSE study. J Am Heart Assoc 2018;7:e008356. DOI:
Sotgiu S, Pugliatti M, Rosati G, et al. Neurological disorders associated with Mycoplasma pneumoniae infection. Eur J Neurol 2003;10:165-8. DOI:
Kong M, Jiang L, Hu J, Ye YZ. [Clinical characteristics of Mycoplasma pneumoniae-associated ischemic stroke in children, and a literature review]. Zhongguo Dang Dai Er Ke Za Zhi 2012;14:823-6. Chinese.
Mélé N, Turc G. Stroke Associated With Recent Mycoplasma Pneumoniae Infection: A Systematic Review of Clinical Features and Presumed Pathophysiological Mechanisms. Front Neurol 2018;9:1109. DOI:

How to Cite

Russo, F., Russo, M. C., & Candurro, C. (2023). Stroke in <i>Mycoplasma pneumoniae</i> pneumonia: a clinical case. Acute Care Medicine Surgery and Anesthesia, 1(1).