Produção Nacional
Revisado por pares
Rhombencephalitis possibly caused by Mycoplasma pneumoniae
2010; Thieme Medical Publishers (Germany); Volume: 68; Issue: 4 Linguagem: Inglês
10.1590/s0004-282x2010000400035
ISSN1678-4227
AutoresPaulo Pereira Christo, Júlio Sérgio P. da Silva, Ilana Vaula Werneck, Sandra Lucia Dias,
Tópico(s)Peripheral Neuropathies and Disorders
Resumoin the absence of atypical pneumonia.CaseA 16-year-old girl, a student, born and living in Minas Gerais state, presented chest and neck pain, low fever, myalgia and coryza. Twenty-four hours after the onset of symptoms, the patient was seen at a ba-sic health clinic and was first treated with common painkillers for viral symptoms, possibly upper airways viral infection. For-ty-eight hours later, the patient presented transitory exanthema, headache, few epi-sodes of vomiting and hyporexia, and con-tinued to be febrile. Reassessment at a sec-ond health clinic showed dysarthria, gait ataxia and mental confusion, in addition to an episode of generalized tonic-clon-ic seizures. A cranial computed tomogra-phy performed 5 days later was normal. There was no report of important person-al or family histories and no history of re-cent travel.Seven days after the onset of symp-toms, the patient was transferred to a ter-tiary care unit where the diagnostic hy-pothesis of HSV-1 meningoencephalitis was raised. At admission, the patient pre-sented a preserved general state and was hydrated, acyanotic and eupneic. Exam-ination of the respiratory and cardiolog-ic system showed no abnormalities. Neu-rological examination showed the patient alert and oriented with isochoric and pho-toreactive pupils, neck stiffness, unaltered cranial nerves, dysmetria on the left side of the body, ataxic gait, normoactive os-teotendinous reflexes, and the presence of a bilateral Babinski sign. Muscle strength and sensitivity were normal.As part of the investigation, cerebro-spinal fluid (CSF) examination showed the following results: leukocytes, 230 cells/mm
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