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Childhood Focal Encephalitis Associated With Positive Cold Agglutinin Titers

Leslie S. Rawitt, MD, FAAP
Am J Dis Child. 1971;121(3):248-249. doi:10.1001/archpedi.1971.02100140114015.
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Focal encephalitis has been attributed to various causes, standard texts listing the more common agents. Generally, however, differential diagnoses do not include those agents associated with positive cold agglutination. The origin of cold agglutinins is unknown. They develop in high titer in patients with Mycoplasma pneumoniae infection but are formed at times in the absence of such infection. It is the purpose of this communication to suggest the possibility that M pneumoniae or related agents may be causally related to severe prolonged focal encephalitis, without pneumonia.

Report of a Case  A 12-year-old white boy was in good health until Nov 10, 1968, at which time he developed a flu-like illness with chills, rhinitis, decreased appetite, and fever. One week later he was still febrile and was treated for two days with tetracycline (dosage unknown). The following day he developed slurred speech, lost control of his balance, was incontinent of urine,

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