Mariotti et al. J Pediatr Neurol Neurosci 2017, 1(1):8-10 *Corresponding author: Viviana Nociti, Department of Geri- atrics, Neurosciences and Orthopedics, Institute of Neurol- ogy, Catholic University, Rome, Italy, Fax: +390635501909, E-mail: viviana.nociti@rm.unicatt.it Received: February 16, 2017; Accepted: May 11, 2017; Published online: May 13, 2017 Citation: Mariotti P, Stefano VD, Stefanini MC, et al. (2017) Stroke in a Child: The Role of Mycoplasma Pneumoniae and Coagulation Factor VIII. J Pediatr Neurol Neurosci 1(1):8-10 Copyright: © 2017 Mariotti P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Clinical Case Open Access • Page 8 • Journal of Pediatric Neurology and Neuroscience ISSN: 2642-4797 | DOI: 10.36959/595/397 | Volume 1 | Issue 1 Stroke in a Child: The Role of Mycoplasma Pneumoniae and Coagulation Factor VIII Paolo Mariotti 1 , Valerio De Stefano 2 , Maria Chiara Stefanini 1,2 , Marco Piastra 3 , Francesco Antonio Losavio 4 and Viviana Nociti 4,5 * 1 Unit of Child Neuropsychiatry, Catholic University, Rome, Italy 2 Institute of Hematology, Catholic University, Rome, Italy 3 Pediatric Intensive Care Unit, Catholic University, Rome, Italy 4 Department of Geriatrics, Neurosciences and Orthopedics, Institute of Neurology, Catholic University, Rome, Italy 5 Don Carlo Gnocchi Foundation, Italy Abstract A 6-year-old child was admitted for an episode of generalized seizures. Shortly afer admission in our Emergency Room, he developed somnolence and meningismus (GCS score 3). A brain magnetic resonance imaging showed signs of stroke. No laboratory fndings were relevant except for an increasing in the coagulation factor VIII levels, so a therapy with heparin sodium was instaured without beneft. An increased serum titer of IgM antibodies for Mycoplasma pneumonia prompted us to introduce a combined therapy with IV clarithromycin and methylprednisolone, leading to a great improvement of symptoms (GCS score 15). Tis case shows that in a rare case of juvenile stroke it is mandatory to search for Mycoplasma infection to avoid a misdiagnosis and compromising the patient's prognosis. Keywords Stroke, Mycoplasma pneumonia, Coagulation Factor VIII Introduction Mycoplasma Pneumoniae (MP) is linked to many neurologic syndromes [1]. Epidemiological studies show that children are more afected by Central Nervous Sys- tem (CNS) manifestations secondary to MP infections than adults [1]. Te pathomechanisms for extrapulmonary manifes- tations of MP infections remain largely unknown [2]. MP-induced CNS diseases have been linked with three broad pathophysiologic mechanisms: 1) Systemic dis- semination with direct infection of extrapulmonary or- gans; 2) Autoimmune or Immune complex-mediated injury; and 3) Vascular occlusion [3]. Stroke has been associated with MP pneumoniae infec- tion both in children and adults [4]. Te pathophysiologic mechanisms underlying MP-associated stroke still is not completely understood. A procoagulable state has been of- ten touted [3]. A systemic or focal vasculitic process is sup- ported by several case reports and animal models [1]. Increased Factor VIII (FVIII) levels are considered a moderately high independent risk factor for ischemic heart disease, ischemic stroke, and venous thromboembolism [5]. Here we describe a case of a child with MP infec- tion-associated stroke and increased FVIII levels. Case Presentation A 6-year-old child came to our Emergency Room for the onset of generalized seizures. Two days earlier he had fever (38 °C), nuchal-occipital throbbing head-