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Gonçalves R, Gata L, Brett A. Mycoplasma pneumoniae-associated mucositis. BMJ Case Rep 2021; 14:14/4/e239086. [PMID: 33858884 PMCID: PMC8054042 DOI: 10.1136/bcr-2020-239086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 9-year-old boy presented to the emergency department of a paediatric hospital with non-painful lesions on his lips and inside his mouth, associated with lip swelling. On examination, his oral mucosa and lips showed numerous blisters with yellowish serofibrinous content and lip oedema. An eye examination revealed bilateral conjunctival injection. Genitalia was unaffected and no other skin lesions were found. He was on day 4 of clarithromycin prescribed for atypical pneumonia caused by Mycoplasma pneumoniae The patient was diagnosed with M. pneumoniae-associated mucositis and was started on topical treatment with fusidic acid and betamethasone, with gradual improvement of the oral lesions.
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Affiliation(s)
- Raquel Gonçalves
- Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Lia Gata
- Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ana Brett
- Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
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De Luigi G, Meoli M, Zgraggen L, Kottanattu L, Simonetti GD, Terrani I, Bianchetti MG, Lava SA, Milani GP. Mucosal Respiratory Syndrome: A Systematic Literature Review. Dermatology 2021; 238:53-59. [PMID: 33774629 PMCID: PMC8089407 DOI: 10.1159/000514815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/25/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Mycoplasma pneumoniae atypical pneumonia is frequently associated with erythema multiforme. Occasionally, a mycoplasma infection does not trigger any cutaneous but exclusively mucosal lesions. The term mucosal respiratory syndrome is employed to denote the latter condition. Available reviews do not address the possible association of mucosal respiratory syndrome with further atypical bacterial pathogens such as Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella species. We therefore performed a systematic review of the literature addressing this issue in the National Library of Medicine, Excerpta Medica, and Web of Science databases. SUMMARY We found 63 patients (≤18 years, n = 36; >18 years, n = 27; 54 males and 9 females) affected by a mucosal respiratory syndrome. Fifty-three cases were temporally associated with a M. pneumoniae and 5 with a C. pneumoniae infection. No cases temporally associated with C. psittaci, C. burnetii, F. tularensis, or Legionella species infection were found. Two cases were temporally associated with Epstein-Barr virus or influenzavirus B, respectively.
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Affiliation(s)
| | - Martina Meoli
- Università della Svizzera Italiana, Lugano, Switzerland
| | | | - Lisa Kottanattu
- Università della Svizzera Italiana, Lugano, Switzerland
- Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Giacomo D. Simonetti
- Università della Svizzera Italiana, Lugano, Switzerland
- Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Isabella Terrani
- Department of Dermatology Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland
| | | | - Sebastiano A.G. Lava
- Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Gregorio P. Milani
- Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Smilga AS, Fournier S, Veillette H, Légaré MÈ, Gilbert M. A rare case of Mycoplasma-induced rash and mucositis in a 44-year-old female patient. JAAD Case Rep 2020; 6:1333-1335. [PMID: 32989421 PMCID: PMC7510416 DOI: 10.1016/j.jdcr.2020.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Anne-Sophie Smilga
- Department of Dermatology, Laval University, Quebec, Quebec, Canada
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
- Correspondence to: Anne-Sophie Smilga, MD, 745-1 rue Sainte-Madeleine, Quebec, Quebec, Canada G1R 3M5.
| | - Suzel Fournier
- Department of Dermatology, Laval University, Quebec, Quebec, Canada
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
| | - Hélène Veillette
- Department of Dermatology, Laval University, Quebec, Quebec, Canada
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
| | - Marie-Ève Légaré
- Department of Ophthalmology and Ear, Nose, and Throat, Laval University, Quebec, Quebec, Canada
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
| | - Martin Gilbert
- Department of Dermatology, Laval University, Quebec, Quebec, Canada
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
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Ashton R, Wong KW, Weinstein M. Pediatric Lip Adhesion Following Bullous Erythema Multiforme and Review of Similar Oral Complications. J Cutan Med Surg 2018; 22:427-430. [DOI: 10.1177/1203475418761038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Erythema multiforme (EM) is a mucocutaneous disease most often associated with preceding herpes simplex virus or Mycoplasma pneumoniae infection. It is characterized by targetoid lesions occurring on the limbs and head and neck. Mucosal involvement can be extensive. Objective: We report a case of lip adhesion as a complication of EM in a child who required corrective surgery and review similar oral commissure complications. Methods: We completed a review of the literature for similar cases using PubMed and Medline. Conclusions and Relevance: We present the youngest report of lip adhesion due to striking mucositis related to EM. Sequelae of erythema multiforme can be significant, in our case requiring surgery. Meticulous oral hygiene should be encouraged when mucosal lesions are identified.
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Affiliation(s)
- Rosalind Ashton
- King’s College London, St John’s Institute of Dermatology, London, UK
| | - Karen W. Wong
- Division of Plastic Surgery, Hospital for Sick Children, Toronto, ON, Canada
| | - Miriam Weinstein
- Division of Paediatric Medicine, Section of Dermatology, Hospital for Sick Children, Toronto, ON, Canada
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Santos RP, Silva M, Vieira AP, Brito C. Mycoplasma pneumoniae-induced rash and mucositis: a recently described entity. BMJ Case Rep 2017; 2017:bcr-2017-220768. [PMID: 28830900 DOI: 10.1136/bcr-2017-220768] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Mycoplasmapneumoniae is a common cause of respiratory infections. Although most cases are mild, some patients have extrapulmonary complications including mucocutaneous eruptions including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and erythemamultiforme (EM). Recently, a new entity, called M. pneumoniae-induced rash and mucositis (MIRM) was described. The authors present a clinical case difficult to classify attending to the classical classification of epidermolytic syndromes that meets the criteria proposed for the diagnosis of MIRM. The mucocutaneous disease associated with M. pneumoniae presents predominant mucositis, with scarce or absent cutaneous involvement. Because of the distinct morphology, pathophysiology and benign clinical course, MIRM should be considered as a new entity, distinct from SJS/TEN and EM.
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Affiliation(s)
- Rui Pedro Santos
- Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal
| | - Marta Silva
- Department of Paediatrics, Hospital de Braga, Braga, Portugal
| | - Ana Paula Vieira
- Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal
| | - Celeste Brito
- Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal
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Terraneo L, Lava SA, Camozzi P, Zgraggen L, Simonetti GD, Bianchetti MG, Milani GP. Unusual Eruptions Associated with Mycoplasma pneumoniae Respiratory Infections: Review of the Literature. Dermatology 2015; 231:152-7. [DOI: 10.1159/000430809] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/18/2015] [Indexed: 11/19/2022] Open
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