Cutaneous leukocytoclastic vasculitis and encephalitis associated with Mycoplasma pneumoniae infection

Mycoplasma pneumoniae infection is generally associated with respiratory symptoms. Abnormalities in almost every organ system have been described as examples of extrapulmonary manifestations.(1) however, skin vasculitis is very rare: we found reports of only 2 cases of serologically confirmed M pneumoniae infection with cutaneous biopsy-proven vasculitis in the English-language literature.(2,3) On the other hand, M pneumoniae causes central nervous system complications such as aseptic meningitis, meningoencephalitis, transverse myelitis, brainstem dysfunction, and Guillain-Barre syndrome, as well as many other Symptoms.(1,4) Three mechanisms for M pneumoniae-associated neurological disease have been postulated: immune-mediated damage, direct invasion of the central nervous system, and production of a neurotoxin by M pneumoniae.(4) We report a case of cutaneous leukocytoclastic vasculitis and encephalitis associated with acute M pneumoniae infection. To our knowledge, this association has not been previously reported.