[Extrapulmonary complications of Mycoplasma pneumoniae infections].

UNLABELLED Mycoplasma pneumoniae is a common etiological factor in atypical pneumonia in children. The course of the disease is usually mild, but in some cases, especially in extrapulmonary localisation, it can pose significant diagnostic and therapeutic problems. The aim of this study was evaluation of extrapulmonary manifestations of Mycoplasma pneumoniae infections in children. MATERIAL AND METHODS Among 21 children with Mycoplasma pneumoniae infection hospitalised in the III Pediatric Clinic, ICZMP in Lodz, between 2001 and 2002 three children with extrapulmonary manifestations of the disease were qualified for the study. The diagnosis was based on a test (from Biotest company) detecting specific IgM, IgG and IgA antibodies. RESULTS In the analysed cases the manifestations of the disease were as follows: exudative gonitis (I), pain in the hip and knee joints (II) and abducens nerve paresis (III). In I case: IgM 1/250; 1/350, IgG- > 1/1000, 1/350; IgA 1/100, negative; in II case: IgM > 1/1000, IgG > 1/1000, IgA negative. In III case IgM 1/450, 1/130; IgG > 1/1000, > 1/1000, IgA 1/300, 1/130. In all the children there were no symptoms form the respiratory tract. In both articular forms, the disease was preceded by Borrelia burgdorferi infection localised in the same joints. Only in case of exudative gonitis an increase in the inflammatory process indexes was noticed. CONCLUSIONS Mycoplasma pneumoniae infection should be considered also in case of extrapulmonary symptoms, with no coexisting infection in the respiratory tract. The forms of extrapulmonary manifestations, in particular concerning the joints and the nervous system, require prolonged and specific antibiotic treatment. Articular manifestation of Mycoplasma pneumoniae infection preceded by articular form of Borrelia burgdorferi infection is noteworthy, and may be caused by abnormal response form the immunological system.