Can Mycoplasma Cause Tactile Hallucinations?
Mycoplasma pneumoniae does not cause tactile hallucinations as a recognized neurological manifestation, though it can cause a wide spectrum of central nervous system complications including encephalitis, cognitive abnormalities, seizures, and altered consciousness. 1, 2
Documented Neurological Manifestations of Mycoplasma
Mycoplasma pneumoniae is well-established as causing neurological complications in approximately 0.1% of infections, but tactile hallucinations are not among the documented presentations. 3 The recognized neurological manifestations include:
Central Nervous System Presentations
- Encephalitis with altered consciousness (58% of cases), lethargy (68%), and cognitive abnormalities 1, 2
- Seizures and pyramidal/extrapyramidal tract dysfunction 2
- Cerebellar dysfunction and ataxia 2, 3
- Progressive encephalomyelitis that can lead to minimally conscious state or locked-in syndrome in severe cases 4
Peripheral and Cranial Nerve Manifestations
- Guillain-Barré syndrome and its variants, including Miller Fisher syndrome (ophthalmoplegia, areflexia, ataxia) 3
- Transverse myelitis with ascending spinal cord syndrome 2, 4
- Optic neuritis and ophthalmoplegia 5
- Peripheral neuritis and polyradiculoneuritis 5
Pathophysiology of Neurological Complications
The neurological manifestations occur through three distinct mechanisms, none of which typically produce tactile hallucinations: 6
- Direct infection type: Local cytokine-mediated damage from direct CNS invasion
- Indirect autoimmune type: Molecular mimicry leading to autoimmune-mediated reactions (most common mechanism) 3, 6
- Vascular occlusion type: Vasculitis or thrombosis affecting neural tissue 6
Clinical Context
When evaluating a patient with suspected Mycoplasma infection and neurological symptoms:
- Typical presentation includes fever, headache, arthralgia, cough, and crackles on auscultation, particularly in school-aged children 7, 8
- Neurological symptoms typically develop after respiratory symptoms, though respiratory symptoms may be absent in up to 56% of cases with CNS involvement 1
- Progression can be rapid (median 2 days from onset to hospitalization) and may require intensive care 1
Important Caveats
If a patient presents with tactile hallucinations in the context of Mycoplasma infection, consider:
- Alternative diagnoses: Tactile hallucinations suggest other etiologies such as delirium tremens, substance withdrawal, or other infectious/metabolic encephalopathies
- Severe encephalitis: While not specifically causing tactile hallucinations, severe Mycoplasma encephalitis can cause profound altered consciousness and cognitive abnormalities that might be mischaracterized 2, 4
- Concurrent conditions: The patient may have both Mycoplasma infection and a separate condition causing the hallucinations
The absence of tactile hallucinations in the extensive literature on Mycoplasma neurological complications strongly suggests this is not a recognized manifestation of the infection. 2, 6, 5