Corticosteroids in the treatment of severe mycoplasma encephalitis in children

Abstract

Objective  

To report an unusual case of mycoplasma-associated encephalitis that responded to corticosteroid therapy and relapsed after cessation.

Design  

Clinical case report.

Setting  

Tertiary care pediatric intensive care unit.

Patient  

A single patient admitted to the pediatric intensive care unit.

Interventions  

Intravenous corticosteroids and antibiotics.

Measurements and Main Results  

Resolution of neurologic symptoms with initial steroid therapy, relapse after withdrawal of steroids, and resolution again with re-institution of steroid therapy.

Conclusions  

Encephalitis is a well-recognized and potentially severe complication of mycoplasma infections. Treatment with corticosteroids has been proposed for this illness, but experience with this therapy is limited to case reports and small series; neither efficacy nor appropriate courses of treatment are well established. The relapsing course of this patient, along with a review of prior reported cases, suggests that corticosteroids may be beneficial for mycoplasma encephalitis, that moderate doses may be sufficient, and that consideration should be given to a prolonged tapering course when these medications are used for this illness.