Neurological manifestations of Mycoplasma pneumoniae infection in hospitalized adults during the 2023–2024 French epidemic, clinical characterisation and comparative outcomes: a multicentre study
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ID: 319755
2026
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Abstract
Abstract Background Mycoplasma pneumoniae (MP) primarily causes respiratory infections but can lead to neurological manifestations. This study aimed to characterize these manifestations in adults during an epidemic. Methods The national MYCADO cohort included 1,309 adults hospitalized with MP infection during the 2023–2024 French epidemic. An ancillary study identified and described MP-related central (CNS) and peripheral (PNS) nervous system manifestations. Data were retrospectively extracted from medical records, with clinical follow-up up to three months after discharge. Results Twenty-eight patients with neurological manifestations attributable to MP were identified (2.1% of the cohort). Of these, 19 affected the CNS, including encephalitis (n=8), myelitis (n=3), encephalo-myelitis (n=2), isolated meningitis (n=6), and cerebral vasculitis (n=1). Nine involved the PNS: Guillain-Barré syndrome (n=6), peripheral polyneuropathy (n=2), and multifocal neuropathy (n=1). Median age was 35 years [IQR 29-49]; 60.7% were men. Neurological symptoms appeared a median of 7 days after MP infection onset. Nearly half (46.4%, n=13) required intensive care; neurological failure was the leading cause for ICU transfer (12/13, 92.3%). Compared to MP patients without neurological manifestations, those with neurological involvement had longer hospital stays (13 vs 9 days, p<0.001), more frequent invasive mechanical ventilation (35.7% vs 4.2%, p<0.001), and more rehabilitation transfers (42.8% vs 4.3%, p<0.001). At discharge, neurological sequelae were present in 47.3% of CNS patients and all GBS patients. At three months, sequelae persisted in 36.8% of CNS patients and all GBS patients. Conclusion In adults, MP infection causes rare but diverse and frequently severe neurological manifestations that worsen clinical course and result in long-term disability.
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| Authors | Matthieu Holub, A Gavaud, Céline Louapre, Alexandre Bleibtreu, Morgane Mailhe, F Goehringer, G. Le Moal, Louis Bohard, Anne Sophie Lecompte, Marine Avenel, C Wemmert, David Luque-Paz, Victor Gerber, Amélie Dureault, Yannick Fedun, Pierre Girardie, Natacha Mrozek, Sophie Leautez‐Nainville, Annabelle Pourbaix, Marion Le Maréchal, David Lebeaux, Charles Cazanave, Valérie Pourcher, G Martin-Blondel, Romain Palich |
| Journal | Open forum infectious diseases |
| Year | 2026 |
| DOI |
10.1093/ofid/ofag406
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| URL | |
| Keywords | Keywords not found |
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