Neurological disease associated with Mycoplasma pneumoniae pneumonitis: demonstration of viable Mycoplasma pneumoniae in cerebrospinal fluid and blood by radioisotopic and immunofluorescent tissue culture techniques
Bayer, A.S.; Galpin, J.E.; Theofilopoulos, A.N.; Guze, L.B.
Annals of Internal Medicine 94(1): 15-20
1981
ISSN/ISBN: 0003-4819 PMID: 6778283 Document Number: 179166
Several neurologic syndromes (including Guillain-Barre) complicated M. pneumoniae pneumonitis in a young man. At onset, buffy coat and CSF cultures on inert media were negative for M. pneumoniae. However, metabolically active mycoplasma were identified in both body fluids by enhanced uptake of 14C-uracil vs. 3H-uridine, with marked reduction in normal uridine-to-uracil uptake ratios (> 1000:1) in tissue culture. Uridine-to-uracil ratios were 8.5:1 and 15:1 for buffy coat and CSF, respectively. Indirect fluorescent antibody (FA) studies confirmed the species as M. pneumoniae. In convalescence, uridine-to-uracil ratios and FA studies of buffy coat normalized, indicating clearance of M. pneumoniae from blood. Cell lines inoculated with convalescent CSF showed slightly increased uracil uptake, slightly decreased uptake ratios, and persistent FA staining of .apprx. 5% of cells, indicating incomplete clearance of M. pneumoniae. Immune complexes were undetectable in either buffy coat or spinal fluid. Certain M. pneumoniae-associated neurologic disorders may be related to direct neural infection and not immunologically mediated as has been suggested.