A case of RIME syndrome of pneumonia caused by atypical pathogens

Immune-mediated dermatoses develop as a result of an inadequate immune response to various triggers (medications, bacterial and viral infections). In 2020, a new term was proposed to combine various mucositis in combination with skin lesions on the background of respiratory infections — reactive infectious mucosal rash (reactive infectious mucosal eruptions, RIME). We present the case of a seventeen-year-old girl with reactive infectious mucocutaneous eruption associated with atypical respiratory pathogens — Chl. pneumoniae and M. pneumoniae. On the 5th day of the disease, against the backdrop of pneumonia, the patient developed an enanthem with lesions of the oral mucosa, conjunctivae, and polymorphic rashes. The diagnosis was confirmed by the detection of IgM and IgG antibodies to Chl. pneumoniae and M. pneumoniae using ELISA. Recovery occurred against the background of etiotropic antibacterial therapy, on the 14th day of the disease, the patient was discharged from the hospital in a satisfactory condition. The case demonstrates the difficulties in diagnosing a rare complication of respiratory infections and emphasizes the need for further research to clarify the tactics of managing patients with skin and mucous reactions.