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CASE REPORT
Korean J Pediatr 2016 March;59(3) :149-152.
Published online 2016 March 15.       
Complete occlusion of the right middle cerebral artery associated with Mycoplasma pneumoniae pneumonia
Ben Kang1, Dong Hyun Kim2, Young Jin Hong2, Byong Kwan Son2, Myung Kwan Lim3, Yon Ho Choe1, Young Se Kwon2
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
3Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
Corresponding Author: Young Se Kwon ,Tel: +82-32-890-3579, Fax: +82-32-890-2844, Email: ysped@inha.ac.kr
Copyright © 2016 by The Korean Pediatric Society
ABSTRACT
We report a case of a 5-year-old girl who developed left hemiparesis and left facial palsy, 6 days after the initiation of fever and respiratory symptoms due to pneumonia. Chest radiography, conducted upon admission, showed pneumonic infiltration and pleural effusion in the left lung field. Brain magnetic resonance imaging showed acute ischemic infarction in the right middle cerebral artery territory. Brain magnetic resonance angiography and transfemoral cerebral angiography revealed complete occlusion of the right middle cerebral artery. Mycoplasma pneumoniae infection was identified by a 4-fold increase in IgG antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. Fibrinogen and D-dimer levels were elevated, while laboratory exams in order to identify other predisposing factors of pediatric stroke were all negative. This is the first reported pediatric case in English literature of a M. pneumoniae-associated cerebral infarction involving complete occlusion of the right middle cerebral artery.
Keywords: Cerebral infarction | Middle cerebral artery infarction | Mycoplasma pneumoniae
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