Mycoplasma pneumoniae-induced rash and mucositis in a 5-year-old child: a case report

Mycoplasma pneumoniae is a common cause of respiratory infections, which in some cases leads to extrapulmonary complications, including mucocutaneous eruptions. The authors describe a clinical case of a 5-year-old Polish boy presenting with symptoms consistent with the diagnostic criteria of Mycoplasma pneumoniae -induced rash and mucositis (MIRM), a relatively new clinical entity distinguished from the spectrum of erythema multiforme (EM), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). The patient was initially admitted to the acute admissions unit of the Children’s Health Centre in Poznan, Poland, due to prolonged fever, erosive-ulcerative lesions of the oral mucosa and lips, and slightly elevated, pink, rash-like skin eruptions. After 2 months, he was followed up in the University outpatient department. The treatment included systemic and local steroids (hydrocortisone, prednisolone), antibiotics (gentamicin), mucolytics (ambroxol), analgesics (paracetamol), and local antifungal agents (nystatin). This report discusses the clinical presentation, diagnostic procedures, differential diagnosis, and treatment. We recommend that pneumonia accompanied by mucocutaneous eruptions, especially in young patients, should raise clinical suspicion of MIRM. Differential diagnosis should include EM, SJS, TEN, and Kawasaki disease.