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Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1112--1113

A Wide Range of High Signal Intensities on Brain Image in Adult Mycoplasma Pneumoniae-Associated Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion

Yutong Zhang1, Qiang Shi2,  
1 Department of Neurology, The Chinese People's Liberation Army General Hospital, Beijing, China
2 Department of Neurology, The Chinese People's Liberation Army General Hospital; Department of National Clinical Research Center of Geriatrics Disease, the Chinese People's Liberation Army General Hospital, Beijing, China

Correspondence Address:
Qiang Shi
Department of Neurology and National Clinical Research Center of Geriatrics Disease, Chinese PLA General Hospital, 28 Fuxing Road, Beijing - 100853
China




How to cite this article:
Zhang Y, Shi Q. A Wide Range of High Signal Intensities on Brain Image in Adult Mycoplasma Pneumoniae-Associated Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion.Neurol India 2021;69:1112-1113


How to cite this URL:
Zhang Y, Shi Q. A Wide Range of High Signal Intensities on Brain Image in Adult Mycoplasma Pneumoniae-Associated Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion. Neurol India [serial online] 2021 [cited 2021 Oct 19 ];69:1112-1113
Available from: https://www.neurologyindia.com/text.asp?2021/69/4/1112/325373


Full Text



A 24-year-old man previously healthy was presented with fever and headache for four days, coupled with restlessness and slurred speech for 1 day. Diffusion-weighted image (DWI) showed a wide range of markedly hyperintense lesions in the white matter around the bilateral lateral ventricle and body of corpus callosum [Figure 1]a. The genu and splenium of corpus callosum were simultaneously affected [Figure 1]b. The antibody tests of mycoplasma pneumoniae were positive, while other tests of antiviral antibodies were all negative. The patient was then treated by injectable azithromycin, 0.5 g per day for 7 days. Following, the clinical symptoms of the patient were relieved and his brain MRI resembled a virtually normal image [Figure 2]a and [Figure 2]b. The diagnosis was mycoplasma pneumoniae-associated mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) type II, which is considered rare for an adult – especially with such a large area of lesion location.{Figure 1}{Figure 2}

MERS has an unclear pathophysiological mechanism and various manifestations. Pneumoniae is one of the causative agents identified in MERS patients.[1] According to the findings on brain imaging, MERS is classified into two types. Type I involved solitary hyperintensity lesions in the splenium of the corpus callosum and type II also involved other brain areas.[2]Azithromycin is useful for the mycoplasma pneumoniae-associated MERS, and the prognosis of this disease is good. The critical point is to recognize it and make the treatment as soon as possible.

Financial support and sponsorship

This work was supported by the National Natural Science Foundation of China (No. 81771358).

Conflicts of interest

There are no conflicts of interest.

References

1Ueda N, Minami S, Akimoto M. Mycoplasma pneumoniae -associated mild encephalitis/encephalopathy with a reversible splenial lesion: Report of two pediatric cases and a comprehensive literature review. BMC Infect Dis2016;16:671.
2Notebaert A, Willems J, Coucke L, Van Coster R, Verhelst H. Expanding the spectrum of MERS type 2 lesions, a particular form of encephalitis. Pediatr Neurol 2013;48:135-8.