Dataset Information

Pseudotumour cerebri associated with mycoplasma pneumoniae infection and treatment with levofloxacin: a case report.

ABSTRACT:

Background

Idiopathic intracranial hypertension (IIH), also known as pseudotumour cerebri syndrome (PTCS), is characterized by the presence of signs and symptoms of raised intracranial pressure without evidence of any intracranial structural cause and with normal cerebrospinal fluid microscopy and biochemistry. Obesity, various systemic diseases and endocrine conditions, and a number of medications are known to be risk factors for PTCS. The medications commonly associated with PTCS are amiodarone, antibiotics, corticosteroids, cyclosporine, growth hormone, oral contraceptives, vitamin A analogues, lithium, phenytoin, NSAIDs, leuprolide acetate, and some neuroleptic drugs. In relation to antibiotics, quinolones may cause intracranial hypertension, and most reported cases of quinolone-induced intracranial hypertension were associated with nalidixic acid, ciprofloxacin, ofloxacin, or pefloxacin. Literature reports of levofloxacin-induced PTCS are rare. Some authors recently hypothesized that Mycoplasma pneumoniae may trigger PTCS.

Case presentation

We report on a 14-year-old overweight White Italian boy who suffered headache, diplopia, and severe bilateral papilloedema after a Mycoplasma pneumoniae infection, exacerbated on levofloxacin intake. A spontaneous improvement in headache and a reduction in diplopia was seen during hospitalisation. Oral acetazolamide therapy led to the regression of papilloedema in about five months. No permanent eye damage has been observed in our patient to date.

Conclusions

PTCS pathophysiology may be multifactorial and its specific features and severity may be a consequence of both constitutional and acquired factors interacting synergistically. It may be useful for paediatricians to know that some antibiotics may have the potential to precipitate PTCS in patients who already have an increased CSF pressure due to a transitory imbalanced CSF circulation caused by infections such as Mycoplasma pneumoniae, with headache being the first and most sensitive, but also the least specific, symptom.

SUBMITTER: Maffeis L

PROVIDER: S-EPMC6320575 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Pseudotumour cerebri associated with mycoplasma pneumoniae infection and treatment with levofloxacin: a case report.

Maffeis Laura L Dilena Robertino R Guez Sophie S Menni Francesca F Bana Cristina C Osnaghi Silvia S Carrabba Giorgio G Marchisio Paola P

BMC pediatrics 20190105 1

<h4>Background</h4>Idiopathic intracranial hypertension (IIH), also known as pseudotumour cerebri syndrome (PTCS), is characterized by the presence of signs and symptoms of raised intracranial pressure without evidence of any intracranial structural cause and with normal cerebrospinal fluid microscopy and biochemistry. Obesity, various systemic diseases and endocrine conditions, and a number of medications are known to be risk factors for PTCS. The medications commonly associated with PTCS are a ...[more]

PMID: 30611233

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Project description:BackgroundMycoplasma pneumoniae (MP) is a common pathogen of community-acquired respiratory infections. The clinical characteristics hospital-acquired MP infections are rarely reported in the literature. Our ward is mainly responsible for the management of patients during the perioperative period of cardiac surgery. Several patients had fever during the improvement of their condition after cardiac surgery, and the effect of upgrading antibiotics and increasing the antibacterial spectrum was not good.MethodsUsing inpatient data of Guangdong Provincial People's Hospital, we conducted a retrospective case series study of hospital-acquired MP infection after cardiac surgery from January 2015 to December 2020 to investigate the clinical characteristics. Clinical data was extracted from patients with a confirmed diagnosis of MP infection after >48 hours of hospitalization. All analyses for this study were descriptive. Data were expressed as mean ± standard deviation (SD), median with range or number with percentage as appropriate.ResultsWe totally included 22 patients. The time of onset of hospital-acquired MP infection after surgery was 23.32±12.57 days, and the duration of antibiotic use before the onset of infection was 4-40 days. Both fever and sore throat were the main symptoms of nosocomial MP infection, and the rash was the most common physical sign. Laboratory tests were normal for peripheral blood leukocyte count and procalcitonin in most patients (17 cases), while the lymphocyte count was decreased in 10 cases. A single serum anti-MP antibody titer ≥1:160 combined with clinical manifestations and imaging helped confirm nosocomial MP infection, although a double serum anti-MP antibody (four-fold change in titer) wasn't seen. With quinolone therapy, such as levofloxacin, all the patients' temperature gradually returned to normal and were discharged uneventfully.ConclusionsPatients after cardiac surgery should be aware of the presence of hospital-acquired MP infection when they develop new fever accompanied by atypical bacterial infection signs such as sore throat and rash during treatment. In such cases, changes in MP antibody titers need to be monitored and anti-MP therapy is required.

Dataset Information

Pseudotumour cerebri associated with mycoplasma pneumoniae infection and treatment with levofloxacin: a case report.

Background

Case presentation

Conclusions

Publications

Pseudotumour cerebri associated with mycoplasma pneumoniae infection and treatment with levofloxacin: a case report.

Similar Datasets

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