Acute Hemorrhagic Leucoencephalitis (AHLE): A Rare CNS Presentation of Mycoplasma pneumoniae

• Published in: Curēus (Palo Alto, CA) Vol. 14; no. 10
• Main Authors: Been Sayeed, S.K. Jakaria, Moniruzzaman, Md, Mahmud, Reaz, Rashid, Mohammad B, Chandra Das, Subir
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 31.10.2022; Cureus
• Subjects: Antibiotics; Antigens; Blood; Case reports; Chicken pox; Coma; Consciousness; Coronaviruses; COVID-19; Cytomegalovirus; Dehydrogenases; Dengue fever; Encephalitis; Enzymes; Hemoglobin; Herpes viruses; Immunoassay; Infections; Infectious Disease; Internal Medicine; Laboratories; Medical imaging; Neurology; Pathogens; Pneumonia; Proteins; Spinal cord; Tuberculosis; Viral infections; Bangladesh
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.30921

Acute hemorrhagic leucoencephalitis (AHLE) is a rare inflammatory disease of the brain. Literature on the presentation and management of this rare disease is limited. A Mycoplasma pneumoniae infection is considered a possible trigger for acute hemorrhagic leucoencephalitis (Weston-Hurst syndrome). We report a case of a 58-year-old man presenting with an altered level of consciousness following a history of acute respiratory tract infection. He had also clinical and laboratory features of disseminated intravascular coagulation (DIC). Brain imaging was suggestive of hemorrhagic encephalitis involving both the fronto-temporo-parieto-occipital lobes involving the cortical, subcortical, and splenium of the corpus callosum and the posterior limb of the right internal capsule. Antibodies against Mycoplasma were strongly positive in serum. The patient was treated with fresh frozen plasma, broad-spectrum antibiotics, and methylprednisolone. However, the patient died after 17 days of hospitalization probably due to multiorgan failure and brain herniation.