Published online December 31, 2007
PEDIATRICS Vol. 121 No. 1 January 2008, pp. 224-225 (doi:10.1542/peds.2007-3038)
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LETTER TO THE EDITOR

Mycoplasma pneumoniae Encephalitis and Cytokines: In Reply

Laura J. Christie, MD
Viral and Rickettsial Disease Laboratory
California Department of Health Services
Richmond, CA 94804
Pediatric Infectious Disease
Children's Hospital Oakland
Oakland, CA 94609

Carol A. Glaser, MD, DVM
Viral and Rickettsial Disease Laboratory
California Department of Health Services
Richmond, CA 94804

We appreciate Dr Narita's letter in response to our article describing Mycoplasma pneumoniae–associated encephalitis in pediatric patients.1 Dr Narita describes 1 potential mechanism of encephalitis associated with M pneumoniae: induction of inflammatory cytokines on entry into the central nervous system.2 We agree that small amounts of organism that fall below the limit of detection by our polymerase chain reaction assays3 may be present in the central nervous system. Degradation of the organism in cerebrospinal fluid during transport could also lead to negative M pneumoniae polymerase chain reaction results. Given the large number of cases of M pneumoniae–associated encephalitis that we have identified and the serious nature of the disorder, we agree that increased emphasis and resources should be directed at investigating the role of steroids, antibiotics, and other treatment options.

REFERENCES

  1. Christie LJ, Honarmand S, Talkington DF, et al. Pediatric encephalitis: what is the role of Mycoplasma pneumoniae? Pediatrics. 2007;120 :305 –313[Abstract/Free Full Text]
  2. Narita M, Tanaka H, Togashi T, Abe S. Cytokines involved in CNS manifestations caused by Mycoplasma pneumoniae. Pediatr Neurol. 2005;33 :105 –109[CrossRef][Web of Science][Medline]
  3. Association of Public Health Laboratories. Real-Time (TaqMan) PCR for Respiratory Bacterial Pathogens. Foster City, CA: Applied Biosystems; 2003
PEDIATRICS (ISSN 1098-4275). ©2008 by the American Academy of Pediatrics

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This Article
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