Mycoplasma pneumoniae-induced rash and mucositis (MIRM): an unusual mild skin rash associated with severe mucosal involvement

Description

A 10-year-old boy was referred to the paediatric department because of ulcerative and haemorrhagic mucosal lesions involving lips and oral cavity (figure 1). These caused significant pain and discomfort to the patient, needing intravenous hydration and nutritional support for some days. The child showed minimal skin involvement, consisting of a mild serpiginous eruption (figure 2), and some lesions were located in the genital and anal areas, too. No pre-existing diseases were reported and, importantly, no drugs were administered during the previous days; interestingly, he reported a self-limiting episode of cough and fever in the previous week. HIV, herpes viruses, cytomegalovirus, Epstein-Barr virus and parvovirus B19 infections were ruled out and no immunological abnormalities emerged. Interestingly, the child presented a serology indicating a recent infection with Mycoplasma pneumoniae, as an elevated specific IgM titre (>27 UA/mL; nv<10 UA/mL) was recovered, whereas the corresponding IgG titre was negative....

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