Case Series: Reactive Infectious Mucocutaneous Eruption (Rime) Associated With Mycoplasma Pneumoniae

Reactive infectious mucocutaneous eruption (RIME) is an infection-associated mucocutaneous disorder characterized by prominent mucositis with limited skin involvement. We present a descriptive case series of 5 pediatric patients presenting with multisite mucositis following febrile respiratory illness. Children in our series were between 6 and 13 years old. All developed extensive mucositis affecting mostly the oral and conjunctival 4 patients showed skin lesions involving <10% BSA, largely consisting of targetoid eruptions. Case 2 had isolated mucosal disease without any skin involvement. Respiratory involvement was noted in 2 patients who developed pneumonia, with one of them (Case 5) having pleural effusion requiring drainage. Investigation showed elevated inflammatory markers and positive M.pneumoniae IgM serology in all cases. Patients were managed with macrolide therapy and supportive care, with favorable outcomes. RIME should be considered in children presenting with predominantly mucosal involvement and limited or absent skin lesions, particularly following a recent respiratory illness.