Mycoplasma pneumoniae -associated central nervous system manifestations: current knowledge and challenges

Background Mycoplasma pneumoniae is a common cause of human respiratory infections. Extrapulmonary manifestations include diseases of the central nervous system. Methods To summarize the current knowledge on M. pneumoniae-associated CNS complications, cases published in PubMed between 2015 and 2025 were reviewed. Results We included 70 studies with 207 patients. Various neurological manifestations were identified, affecting patients between the ages of 3 and 69. Cases of encephalitis predominated (72%). Diagnosis of M. pneumoniae involvement was confirmed primarily by the detection of specific antibodies in serum. The prodromal phase between respiratory and neurological symptoms (<7 days vs. ≥7 days) was distributed almost evenly. In most cases, antibiotics effective against mycoplasma are used (88%) and in 81% of patients, complete recovery was achieved. Conclusions While the administration of antibiotics is accepted for the treatment of CNS manifestations, the use of other therapies is guided by the severity of the course and empirical considerations.