Medical Case Reports

Introduction

Mycoplasmas are the littlest prokaryotic microorganisms in nature. Post-Mycoplasma pneumoniae infection, there have been numerous reports of stroke, particularly among children. However, stroke has never been linked to Mycoplasma hominis infection. We present the case of a 36-year-old Greek woman who had an unidentified cause for an extensive stroke. She had a simultaneous genital contamination with Mycoplasma hominis for an obscure term. Adult disability and preventable death are largely attributable to stroke. Although infections are not thought to be directly responsible, they have been linked to stroke. Their significance has been emphasized in stroke patients of unknown etiology and in particular patient populations, such as young patients without traditional risk factors and immunocompromised patients. The by and large detailed predominance of intense diseases goes from 18 to 40% in the month going before intense ischemic stroke beginning, and from 10 to 40% in the week going before stroke. Multiple immunohematologic changes that cause plaque rupture and a procoagulant state have been linked to this connection.

Mycoplasma Hominis Infection

Infection has not been found to play a causal role in ischemic stroke in any of the studies conducted thus far. However, our case report suggests that an infection may cause an ischemic stroke and temporarily raise the risk. A 36-year-old Greek woman presented with vomiting and acute onset of dizziness. She didn't have a background marked by liquor/substance misuse or physically sent infections. The patient had no children. She was single, according to her family, and at the time of the incident, she did not have any known medical conditions that necessitated medication. She smoked two packs of cigarettes per day. Other than the patient's adolescent diagnosis of polycystic ovarian syndrome, her sister provided no known obstetrical and gynecological history. When the stroke occurred, the patient was working as a caregiver for an elderly couple and living with them round-the-clock. At first, she went to a regional hospital and saw a local doctor. When her symptoms improved, she received Intramuscular (IM) diphenhydramine treatment and was discharged. Additionally, she received antibiotic tablets containing amoxicillin and clavulanic acid to treat two suprapubic skin ulcers. After two days, the patient became lazy and was confessed to the medical clinic crisis division for additional examination. The patient presented with miotic pupils and a fluctuating Glasgow Coma Scale (GCS) score between 7 and 8/15 during her initial examination. She withdrew from painful stimuli, only opened her eyes to painful stimulation, did not respond verbally, and rarely made incomprehensible sounds. She was unable to participate, however she had the option to move every one of her appendages against gravity, and introduced flat nystagmus and esophoria of the right eye. Her tendon reflexes were symmetrical on both sides, and her plantar reflexes were normal. Her circulatory strain at confirmation was 175/100 mmHg, her heartbeat rate was 95 bpm, and she had no fever (T = 36.8 °C). A hypodense lesion on the left cerebellum hemisphere that was putting pressure on the fourth ventricle was seen on brain Computed Tomography (CT). If her clinical status remained stable, the neurosurgical assessment suggested that she require close monitoring, an MRI, and a re-evaluation within 12 hours. The patient was treated with bolus mannitol to diminish cerebral edema, and she recaptured awareness (GCS 15/15). After she regained consciousness, her neurological examination revealed that her pupils were the same size and had a normal response to light. She could not converge or look downward, had diplopia in her left eye, left facial palsy, and horizontal nystagmus to the left. Despite the patient's limited cooperation, there was no evident paresis of the upper or lower limbs or sensation abnormality. She couldn't sit or stand due to outrageous tipsiness and sickness. She had a sPO2 of 95%, a heart rate of 99 beats per minute, a respiratory rate of 15 breaths per minute, normal arterial blood gas values, and fingerstick glucose of 208 mg/dl. She did not have a fever.

Mycoplasma Pneumoniae

A hematologist assessed the slight height in the proportion of globulins to egg whites, which was credited to disease. A CT scan of the abdomen revealed no pathological locations. A skin biopsy determined that there were no other systematically causing stroke-related skin lesions. The histopathological results revealed were characteristic of Sweet disorder. After affirmation, the patient had dim hued vaginal release and tingling in the outside genital organs. She continued to have dark-colored vaginal discharge after 14 days of antibiotic therapy and multiple negative blood and urine cultures for common bacteria. Under sterile conditions, all blood and urine cultures were collected at the bedside. Since the patient never had a fever, blood cultures were taken every time from two to three different locations, always in temperature-controlled conditions. Societies were performed for normal vigorous and anaerobic microorganisms, and growths. For Listeria monocytogenes, Borrelia burgdorferi, Mycoplasma Pneumoniae (MP), and Ureaplasma ureolyticum, additional serum antibody tests were ordered. There was no sign of infection. The skin reaction to Mantoux was also negative. A culture of the vaginal release got during obstetric assessment tried positive for Mycoplasma hominis. Antimicrobial treatment was recommended with doxycycline, isoconazole nitrate and diflucortolone valerate for outside use, as well as fluconazole on account of Candida non-albicans codisease. Tandem mass spectrometry on a dried blood spot was also used to test the patient for Fabry disease (a-galactosidase, lyso-GL-3) but came back negative. After recuperation, the patient continuously became versatile, and a mental change was obvious, including close to home unsteadiness, created recollections, sexual incoherence and an absence of hindrance. A mind X-ray exhibited an intense ischemic stroke with restricted hemorrhagic parts in the left cerebellum half of the globe and the left piece of the vermis, and strain on the fourth ventricle. Symmetric thalamic infarcts were additionally noticed. A new MRI was carried out after a mild deterioration with projectile vomiting on the seventh day following admission. In the right cerebellum hemisphere, a new, smaller acute ischemic stroke was discovered.