Mycoplasma pneumoniaeassociated transverse myelitis presenting as asymmetric flaccid paralysis

Salloum, Shafee; Goenka, Ajay; Ey, Elizabeth

The proposed mechanisms for mycoplasma induced neurological complications are direct central nervous system invasion or a post-infectious immune process. The latter is probably due to molecular antigenic mimicry between M. pneumoniae and myelin sheath proteins leading to production of anti-neuronal antibodies. 6, 7 M. pneumoniae infection can be a diagnostic challenge as serologic antibodies are neither sensitive nor specific, and detection of DNA by PCR in respiratory specimens may represent colonization rather than an active infection. 6 We suspect that ATM in this case is most likely due to M. pneumoniae infection which is evident by elevated intrathecal antibodies and absence of other pathogens. Serum M. pneumoniae antibodies were not obtained in this case due to their poor sensitivity and specificity as mentioned above.