Poster Presentation Australian and New Zealand Stroke Organisation Conference 2025

Mycoplasma pneumonia: a case series of a rare cause of young stroke (#113)

Krishna Rajan 1 , Jennifer Merrix 1 , Martin Punter 1 2
  1. Neurology, Wellington Regional Hospital, Wellington, WELLINGTON, New Zealand
  2. Medicine, University of Otago, Wellington, New Zealand

Background and Aims

Mycoplasma pneumoniae is a common cause of atypical community acquired pneumonia (CAP). Mycoplasma is typically spread via respiratory droplet and is therefore implicated in local respiratory infection outbreaks every few years. Owing to its complex pathophysiology, Mycoplasma is often associated with multiple extrapulmonary presentations. These include transverse myelitis, acute hepatitis, and as discussed here, thromboembolism. Posited aetiologies for these involve activation of inflammatory cytokines and formation of autoimmune antibodies. Additionally, indiscriminate activation of the coagulation cascade has been implicated in thrombophilia and consumptive thrombocytopenia.

Methods and Results

In this poster, we will discuss two cases of large vessel occlusion (LVO) ischaemic stroke in young, fit, patients with no traditional cardiovascular risk factors. Our first case is a 28 year-old male fencer with no medical background presenting with a right middle cerebral artery occlusion and respiratory compromise, requiring mechanical thrombectomy. Our second case is a 35 year-old female nurse presenting with a left MCA and anterior cerebral artery occlusion, with bilateral pulmonary emboli. Both patients had proven Mycoplasma-associated CAP prior to presentation. 

Conclusion

Mycoplasma pneumoniae is a common, but rarely life-threatening respiratory infection. However, owing to its inherently inflammatory nature, it is associated with significant thrombosis. This poster describes two cases of patients with no traditional cardiovascular risk factors who had a baseline Mycoplasma-associated CAP, with large vessel ischaemic strokes. We aim to shed light into investigating a rare, but described and treatable risk of acute ischaemic stroke. 

 

  1. Mycoplasma pneumoniae infection - Fact sheets. www.health.nsw.gov.au. Published May 23, 2024. https://www.health.nsw.gov.au/Infectious/factsheets/Pages/mycoplasma-pneumoniae.aspx
  2. Chiang CH, Huang CC, Chan WL, et al. Association Between Mycoplasma Pneumonia and Increased Risk of Ischemic Stroke. Stroke. 2011;42(10):2940-2943. doi:https://doi.org/10.1161/strokeaha.110.608075