BMJ Case Reports 2018; doi:10.1136/bcr-2017-221831
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Mycoplasma pneumoniae infection presenting as stroke and meningoencephalitis with aortic and subclavian aneurysms without pulmonary involvement

Open Access
  1. Jihad Inshasi
  1. Department of Neurology, Rashid Hospital, Dubai, United Arab Emirates
  1. Correspondence to Dr Pournamy Sarathchandran, pournamydr{at}
  • Accepted 26 December 2017
  • Published 11 January 2018


A 39-year-old Philipino man presented with acute onset fever and headache. Neurological examination was normal except for neck stiffness. There was no history of chest pain, cough or breathlessness. Cerebrospinal fluid (CSF) showed a mild increase in protein with normal sugar and lymphocytic pleocytosis. CSF PCR for herpes simplex and varicella zoster virus was negative. He developed acute right haemiplegia a week after hospitalisation. MRI showed acute infarct in the left centrum semiovale. His angiogram showed aneurysm in the left subclavian artery and aortic arch. The mycoplasma antibody test came positive with very high titres, while rest of the workup was negative. He was treated with azithromycin and his symptoms improved completely.

He was asymptomatic on follow-up after a month. His repeat immunoglobulin G mycoplasma antibody titre showed elevation. Mycoplasma infection is a treatable cause of meningoencephalitis and stroke secondary to vasculitis. Arterial aneurysms are known to occur with mycoplasma infection although rare.


  • Contributors PS: primarily responsible for the design of the work; acquisition of data, analysis and drafting the work. AMA, AARAM and JI: assisted in the design of the work; acquisition of data, analysis, drafting the work and review of final version.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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