A case of toxic epidermal necrolysis in a paediatric patient with mycoplasma pneumoniae infection

Toxic Epidermal Necrolysis (TEN) is a rare, life-endangering emergency condition with a high mortality rate. While medications are recognized as common trigger factors, infections like Mycoplasma pneumoniae are also increasingly being recognized as other potential triggers, particularly in the paediatric population. A 6-year-old boy presented with fever, sore throat and tender skin lesions that rapidly progressed from erythema, macular rash to multiple vesicles, flaccid bullae and erosion, affecting more than 70% of total body surface area. Epidermal necrolysis affects more than 30% of the total body surface area including genital, oral and conjunctival mucus membranes. A diagnosis of Toxic Epidermal Necrolysis was established. Laboratory tests confirmed Mycoplasma pneumoniae infection and a chest Х-ray revealed pneumonia. For management of TEN, IVIG, followed by Methylprednisolone pulses were in combination. This was combined with antibacterial therapy and supportive care. The patient made a complete recovery with no complications after 36 days under Intensive Care. This case underscores Mycoplasma pneumoniae as a paediatric TEN trigger. It also serves to highlight the efficacy of combined immunotherapy and multidisciplinary care and the importance of early intervention in minimizing complications, especially in such severe cases.