Table 1.
Pediatric cases of MERS associated with Mycoplasma pneumoniae infection
| Age (yrs) | Sex | Duration of prodromal illness (d) | Neurological symptoms | Non-neurological symptoms | Duration of fever (d) | Diagnosic method for MP | Diagnosis of MP-associated encephalitis | MR | Chest | WBC | CRP | Na | CSF | EEG | MRI | Time till recovery of MRI findings (d) | Time till clinical recovery (d) | Treatment | Outcome | Ref | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| X-ray/CT | (cells/μL) | (mg/dl) | (mEq/L) | finding | findings | Antibiotics | Steroids | ||||||||||||||
| 13 | M | 1 | Abnormal speech, ataxia, confusion, drowsiness | Abd pain, fever, lethargy | NA | IgMAb/CFT | probable | NA | NA | 7,950 | 0.1 | NA | pleocytosis | SW | type II, SCC, center semiovale, genu, parietal | 90 | 180 | CIP | – | CR | [5] |
| 3 | F | 3 | Drowsiness, seizure | Diarrhea, fever, vomiting | 6 | IgMAb/EIA | possible | NA | NA | normal | – | NA | normal | NA | type I | 60 | 3 | AZT | – | CR | [12] |
| 8 | M | 2 | Ataxia, confusion, drowsiness | Fever, lethargy | 6 | IgMAb/EIA | possible | NA | NA | increased | + | NA | normal | NA | type I | 6 | 8 | AZT | + | CR | [12] |
| 9 | M | 1 | Drowsiness, left peripheral facial nerve paralysis | Fever, headache, lethargy, vomiting | 2 | IgMAb/ELISA MP (+) in PS by PCR |
possible | NA | NA | 4,500 | 1.6 | 127 | normal MP (−) in CSF by PCR |
SW | type I | 7 | 10 | AZT | – | CR | [13] |
| 12 | M | 6 | Drowsiness | Cough, dizziness, fever, headache, lethargy, vomiting | 6 | IgMAb/ELISA MP (+) in PS by PCR |
possible | NA | IF | 8,100 | 1.4 | 139 | normal MP (−) in CSF by PCR IL-6↑ |
SW | type I | 3 | 8 | AZT | – | CR | [13] |
| 2 | M | 2 | Abnormal speech, irritability, motor deterioration, seizure | Abd.pain, fever, vomiting | 2 | ELISA | possible | NA | NA | 11,600 | 6.6 | 136 | normal | normal | type I | 120 | 8 | NA | – | CR | [14] |
| 6 | M | 4 | Abnormal speech, delilium, drowsiness | Abd.pain, fever, headache | 4 | ELISA | possible | NA | NA | 12,600 | 16.8 | 135 | normal | SW | type I | 67 | 19 | NA | + | CR | [14] |
| 6 | M | 6 | Drowsiness, irritability | Cough, fever, headache | 10 | PA | probable | + | IBM | 11,800 | 0.33 | 135 | pleocytosis | SW | type I | 18 | 12 | CIP | – | CR | [15] |
| 8 | F | 1 | Ataxia, muscle weakness, tremor | Cough, fever | NA | PA | probable | NA | IF | 8,000 | 5.72 | 136 | ND | NA | type I | 8 | 8 | NA | NA | CR | [16] |
| 10 | F | 1 | Drowsiness | Cough | 0 | PA | probable | NA | IF | NA | NA | NA | ND | NA | type I | 15 | 4 | NA | NA | CR | [17] |
| 12 | F | 7 | Abnormal behavior, drowsiness, seizure | Fever | NA | NA | possible | NA | NA | NA | NA | NA | NA | NA | type I | NA | 10 | NA | + | CR | [18] |
| 6 | F | 4 | Delirium | Cough, fever | 8 | NA | possible | + | IF | NA | NA | NA | ND | NA | type I | 11 | 8 | CIP | NA | CR | [19] |
| 7 | M | 8 | Abnormal speech, drowsines | Cough, fever, headache | 6 | PA | probable | NA | NA | 16,400 | 1.1 | 131 | pleocytosis MP (−) in CSF by PCR |
normal | type I | 4 | 4 | MINO | + | CR | [20] |
| 14 | M | 5 | Abnormal speech/behavior, delirium, drowsiness, hallucinations | Cough, fever, headache | 5 | IgMAb/EIA | possible | + | IF | 7,680 | 2.6 | 134 | ND | ND | type I | 7 | 7 | MINO | + | CR | Case1 |
| 8 | F | 1 | Ataxia, drowsiness, intension tremor, seizure | Cough, diarrhea, fever, headache, lethargy, vomiting | 9 | IgMAb/EIA | possible | NA | IBM | 6,480 | <0.3 | 133 | ND | normal | type II,SCC, left cerebellum | 7 | 60 | MINO | – | CR | Case2 |
Ab antibody, Abd abdominal, AZT azithromycin, CFT complement fixation test, CIP ciprofloxacin, CR complete recovery, CRP C-reactive protein. CSF cerebrospinal fluid, CT computed tomography, EEG electroencephalography, EIA enzyme immunoassay, ELISA enzyme-linked immusorbent assay, IBM increased bronchial markings, IF infiltration, IL interleukin, MINO minocycline, MERS mild encephalitis/encephalopathy with a reversible splenial lesion, MP Mycoplasma pneumoniae, MR macrolide (clarithromycin) resistance, MRI magnetic resonance imaging, PA particle agglutination assay, PCR polymerase chain reaction, PS pharyngeal swab sample, SCC splenium of the corpus callosum, SW slow wave, WBC white blood cell. ↑ increase, ND not done, NA not available