Pediatric pseudomembranous pharyngitis caused by mycoplasma pneumoniae and herpes simplex virus type 2: a case report

Pseudomembranous pharyngitis (PMP) is rare in immunocompetent individuals, with no reported cases in minors caused by Mycoplasma pneumoniae (M. pneumoniae) and herpes simplex virus type 2(HSV-2)coinfection. We describe a 16-year-old immunocompetent male with PMP refractory to conventional antibiotics and intravenous corticosteroids. Metagenomic sequencing confirmed M. pneumoniae/HSV-2 coinfection; azithromycin plus nebulized budesonide achieved complete clinical and laryngoscopic resolution. To our knowledge, this may be the first reported case highlights M. pneumoniae as a key potential PMP pathogen in immunocompetent pediatric patients, and supports targeted antibiotics combined with nebulized glucocorticoids for such refractory cases.