1
|
Li RM, Long Z, Ding XY, Duan L. Oral microbiota imbalance: A predisposing factor for Henoch-Schönlein Purpura in children. Heliyon 2024; 10:e28826. [PMID: 38596127 PMCID: PMC11002595 DOI: 10.1016/j.heliyon.2024.e28826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Oral microecological dysregulation has been shown to be associated with various immune system disorders. Henoch-schonlein purpura (HSP) is an autoimmune small vessel inflammatory disease in children of uncertain etiology, and studies have suggested that streptococcal infection may be an influential factor in its development. However, the relationship between oral microecological dysregulation and HSP has not been clearly studied so far. In this study, an epidemiological survey on the oral health status of children with HSP was investigated in this paper, and collected dental plaque from four groups of children for 16SrDNA high-throughput sequencing to analyze the composition and changes of oral microbial diversity among different groups. The results showed that the oral health status of children with HSP was poor, except for the incidence of caries in the 5-year-old group, the caries rate and dmfs/DMFS in the 3,4 and 5-year-old groups were higher than the same age in the fourth Chinese Oral Health Epidemiological Survey. Moreover, the development of HSP is accompanied by disturbances in the oral microbiota; a decrease in the number of Firmicutes which producing butyric acid may be closely associated with the development of HSP; changes in the abundance of Streptococcus and Neisseria may be a risk factor for the development of HSP.
Collapse
Affiliation(s)
- Rui min Li
- Department of Operative Dentistry and Endodontics, Stomatology Hospital of General Hospital, Ningxia Medical University, China
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| | - Zhe Long
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| | - Xiao yan Ding
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| | - Li Duan
- Ningxia Medical University, China
- Ningxia Key Laboratory of Oral Disease Research, China
| |
Collapse
|
2
|
Trapani S, Rubino C, Lodi L, Resti M, Indolfi G. Erythema Nodosum in Children: A Narrative Review and a Practical Approach. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9040511. [PMID: 35455555 PMCID: PMC9025345 DOI: 10.3390/children9040511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/22/2022]
Abstract
Erythema nodosum (EN) is the most frequent form of panniculitis in children. We performed a literature review analyzing studies on pediatric EN published from 1990 to February 2022. EN is rare in pediatric age. It can be primary/idiopathic in 23–55% cases, or secondary in 47–77% cases. Secondary EN is related to a wide variety of conditions including infectious diseases, autoimmune disorders, malignancy, drugs, vaccinations, and pregnancy. The diagnosis of EN is clinical, based on the acute appearance of painful and red nodules localized to lower limbs, bilaterally distributed. If EN is diagnosed, basic work-up should include inflammatory markers, serum aminotransferases, lactate dehydrogenase, creatinine, protein electrophoresis, immunoglobulins, testing for streptococcal infection, and a tuberculin skin test. Based on the medical history and associated manifestations, further laboratory and radiological exams should be performed. The prognosis of EN is excellent, with spontaneous resolution in most patients within 2–6 weeks. Treatment, if needed, is addressed to the underlying condition. Despite being a rare manifestation in children, EN can be isolated or the first manifestation of a systemic or infectious condition. EN diagnosis is clinical, and a high index of suspicion is needed to perform investigations for the underlying disorders.
Collapse
Affiliation(s)
- Sandra Trapani
- Pediatric Unit, Department of Health Sciences, Meyer Children’s University Hospital, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy
- Correspondence: ; Tel.: +39-055-5662480
| | - Chiara Rubino
- Pediatric Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy; (C.R.); (M.R.)
| | - Lorenzo Lodi
- Immunology and Molecular Microbiology Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
| | - Massimo Resti
- Pediatric Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy; (C.R.); (M.R.)
| | - Giuseppe Indolfi
- Pediatric Unit, Department of NEUROFARBA, Meyer Children’s University Hospital University of Florence, Viale Pieraccini 24, 50137 Florence, Italy;
| |
Collapse
|
3
|
Atypical Bacterial Pathogens and Small-Vessel Leukocytoclastic Vasculitis of the Skin in Children: Systematic Literature Review. Pathogens 2021; 10:pathogens10010031. [PMID: 33401725 PMCID: PMC7823485 DOI: 10.3390/pathogens10010031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 11/17/2022] Open
Abstract
Leukocytoclastic small-vessel vasculitis of the skin (with or without systemic involvement) is often preceded by infections such as common cold, tonsillopharyngitis, or otitis media. Our purpose was to document pediatric (≤18 years) cases preceded by a symptomatic disease caused by an atypical bacterial pathogen. We performed a literature search following the Preferred Reporting of Systematic Reviews and Meta-Analyses guidelines. We retained 19 reports including 22 cases (13 females and 9 males, 1.0 to 17, median 6.3 years of age) associated with a Mycoplasma pneumoniae infection. We did not find any case linked to Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella pneumophila. Patients with a systemic vasculitis (N = 14) and with a skin-limited (N = 8) vasculitis did not significantly differ with respect to gender and age. The time to recovery was ≤12 weeks in all patients with this information. In conclusion, a cutaneous small-vessel vasculitis with or without systemic involvement may occur in childhood after an infection caused by the atypical bacterial pathogen Mycoplasma pneumoniae. The clinical picture and the course of cases preceded by recognized triggers and by this atypical pathogen are indistinguishable.
Collapse
|
4
|
Triggers, clinical manifestations, and management of pediatric erythema multiforme: A systematic review. J Am Acad Dermatol 2019; 81:813-822. [PMID: 31331726 DOI: 10.1016/j.jaad.2019.02.057] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/20/2019] [Accepted: 02/24/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Erythema multiforme (EM) is an acute inflammatory mucocutaneous condition. EM is rarely described in children and infants. OBJECTIVE To investigate the triggers, clinical manifestations, and treatment of pediatric EM. METHODS Systematic literature review of pediatric EM. RESULTS After full-text article review, we included 113 articles, representing 580 patients. The mean age was 5.6 years, ranging 0.1-17 years. Infectious agents were the main triggers: herpes simplex virus (HSV) in 104 patients (17.9%) and Mycoplasma pneumoniae in 91 patients (15.7%). In total, 140 cases (24.1%) were drug-related and 89 cases (15.3%) had other triggers, such as vaccines (19 patients, 3.2%). In total, 229 patients had EM major (39.5%). Treatment was supportive care only (180 patients, 31.1%), systemic corticosteroids (115 patients, 19.8%), antivirals (85 patients, 14.6%), and antibiotics (66 patients, 11.3%), mostly macrolides (45 patients, 7.7%). Long-term sequelae were rare (1.3%). Pediatric EM was reported in 19 infants (3.2%). The main trigger was vaccination (9 patients). Infantile EM was EM major in 2 cases and EM minor in 17. Infants were less prone to develop EM major than older children (P < .01). Pediatric EM was recurrent in 83 cases (14.3%), which was triggered by HSV in 36 patients (61%). Recurrence affected older children. LIMITATIONS Potential confusion between Steven Johnson syndrome and EM major in addition to publication bias. CONCLUSION Pediatric EM is a rare disease, mainly triggered by infections. This condition can affect all mucosal surfaces, most commonly the oral mucosae. The diagnosis is clinical, and management relies on supportive care. Vaccines are a particular trigger in infants. Recurrent cases are most commonly linked to HSV. Dermatologists and pediatricians should be aware of this potentially recurrent and severe condition.
Collapse
|
5
|
Ozbagcivan O, Akarsu S, Avci C, Inci BB, Fetil E. Examination of the Microbial Spectrum in the Etiology of Erythema Nodosum: A Retrospective Descriptive Study. J Immunol Res 2017; 2017:8139591. [PMID: 28634591 PMCID: PMC5467334 DOI: 10.1155/2017/8139591] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/14/2017] [Accepted: 05/04/2017] [Indexed: 12/18/2022] Open
Abstract
Even though infections are the most common cause of erythema nodosum (EN), only certain microorganisms take the great interest such as streptococci in knowledge. Our aim was to examine the frequency and type of infections in EN, to determine the characteristics of patients with an infectious etiology, and to discuss the role of these microbes in EN pathology in the context of their interactions with humans. Charts of 81 patients with EN who were seen between 2003 and 2017 were retrospectively reviewed. Identified etiological factors were classified into three groups: infectious, noninfectious, and idiopathic. While there were no significant demographic and clinical differences between the infectious and idiopathic groups, systemic symptoms (p = 0.034) and the number of EN lesions (p = 0.016) were significantly lower; the mean erythrocyte sedimentation rate was significantly higher (p = 0.049), but the mean aspartate aminotransferase value was significantly lower in the infectious group compared to the noninfectious group (p = 0.019). Besides streptococci, many other microbes, including the ones living on and inside us, were identified in the etiology of EN. There is a need for large-scale prospective studies involving control groups for a better understanding of the microbial immunopathology of EN.
Collapse
Affiliation(s)
- Ozlem Ozbagcivan
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Sevgi Akarsu
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ceylan Avci
- Department of Dermatology, Bilecik State Hospital, Bilecik, Turkey
| | - Burcu Bahar Inci
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Emel Fetil
- Department of Dermatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
6
|
Abstract
OBJECTIVES Erythema multiforme (EM) is characterized by symmetrical acrally distributed target lesions; however, other conditions can mimic the clinical features of EM. Although it is typically self-limiting, alternative diagnoses may be life-threatening and require immediate identification and treatment. This study aimed to investigate the clinical spectrum and accuracy of diagnosis of pediatric EM in the emergency department (ED). METHODS A retrospective, descriptive study of all pediatric patients with an ED information system diagnosis of EM at 2 EDs in Southeast Queensland between January 2010 and July 2013. Cases were evaluated using previously established EM classification criteria. RESULTS Seventy patients (34 males and 36 females) with a diagnosis of EM were identified. From 57 cases where a diagnosis could be established, 9 cases fulfilled the classification criteria for EM. No patients had mucosal involvement, and therefore, all 9 cases were classified as EM minor, with the majority (89%) attributed to viral infection. Of the 48 cases that did not fit the criteria, the most common condition misdiagnosed as EM was urticaria multiforme (n = 20). CONCLUSIONS In the ED setting, EM in children is frequently misdiagnosed. Greater awareness of diagnostic factors for EM may improve diagnostic accuracy. Teledermatology and incentives to include clinical pictures in the (electronic) medical record may be useful adjuncts for patients with suspected EM and other dermatological conditions.
Collapse
|
7
|
Parrott GL, Kinjo T, Fujita J. A Compendium for Mycoplasma pneumoniae. Front Microbiol 2016; 7:513. [PMID: 27148202 PMCID: PMC4828434 DOI: 10.3389/fmicb.2016.00513] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Historically, atypical pneumonia was a term used to describe an unusual presentation of pneumonia. Currently, it is used to describe the multitude of symptoms juxtaposing the classic symptoms found in cases of pneumococcal pneumonia. Specifically, atypical pneumonia is a syndrome resulting from a relatively common group of pathogens including Chlamydophila sp., and Mycoplasma pneumoniae. The incidence of M. pneumoniae pneumonia in adults is less than the burden experienced by children. Transmission rates among families indicate children may act as a reservoir and maintain contagiousness over a long period of time ranging from months to years. In adults, M. pneumoniae typically produces a mild, “walking” pneumonia and is considered to be one of the causes of persistent cough in patients. M. pneumoniae has also been shown to trigger the exacerbation of other lung diseases. It has been repeatedly detected in patients with bronchitis, asthma, chronic obstructive pulmonary disorder, and cystic fibrosis. Recent advances in technology allow for the rapid diagnosis of M. pneumoniae through the use of polymerase chain reaction or rapid antigen tests. With this, more effort has been afforded to identify the causative etiologic agent in all cases of pneumonia. However, previous practices, including the overprescribing of macrolide treatment in China and Japan, have created increased incidence of macrolide-resistant M. pneumoniae. Reports from these countries indicate that >85% of M. pneumoniae pneumonia pediatric cases are macrolide-resistant. Despite its extensively studied past, the smallest bacterial species still inspires some of the largest questions. The developments in microbiology, diagnostic features and techniques, epidemiology, treatment and vaccines, and upper respiratory conditions associated with M. pneumoniae in adult populations are included within this review.
Collapse
Affiliation(s)
- Gretchen L Parrott
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| | - Takeshi Kinjo
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| | - Jiro Fujita
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| |
Collapse
|
8
|
Narita M. Classification of Extrapulmonary Manifestations Due to Mycoplasma pneumoniae Infection on the Basis of Possible Pathogenesis. Front Microbiol 2016; 7:23. [PMID: 26858701 PMCID: PMC4729911 DOI: 10.3389/fmicb.2016.00023] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/11/2016] [Indexed: 01/22/2023] Open
Abstract
The list of extrapulmonary manifestations due to Mycoplasma pneumoniae infection can be classified according to the following three possible mechanisms derived from the established biological activity of M. pneumoniae; (1) a direct type in which the bacterium is present at the site of inflammation and local inflammatory cytokines induced by the bacterium play an important role (2) an indirect type in which the bacterium is not present at the site of inflammation and immune modulations, such as autoimmunity or formation of immune complexes, play an important role, and (3) a vascular occlusion type in which obstruction of blood flow induced either directly or indirectly by the bacterium plays an important role. Recent studies concerning extrapulmonary manifestations have prompted the author to upgrade the list, including cardiac and aortic thrombi as cardiovascular manifestations; erythema nodosum, cutaneous leukocytoclastic vasculitis, and subcorneal pustular dermatosis as dermatological manifestations; acute cerebellar ataxia, opsoclonus-myoclonus syndrome, and thalamic necrosis as neurological manifestations; pulmonary embolism as a respiratory system manifestation; and renal artery embolism as a urogenital tract manifestation. Continuing nosological confusion on M. pneumoniae–induced mucositis (without skin lesions), which may be called M. pneumoniae-associated mucositis or M. pneumoniae-induced rash and mucositis separately from Stevens-Johnson syndrome, is argued in the dermatological manifestations. Serological methods are recommended for diagnosis because pneumonia or respiratory symptoms are often minimal or even absent in extrapulmonary manifestations due to M. pneumoniae infection. Concomitant use of immunomodulators, such as corticosteroids or immunoglobulins with antibiotics effective against M. pneumoniae, can be considered as treatment modalities for most severe cases, such as encephalitis. Further studies would be necessary to construct a comprehensive therapeutic strategy, covering microbiology (antibiotics), immunology (immunomodulators), and hematology (anticoagulants). The possible influence of the emergence of macrolide-resistant M. pneumoniae on extrapulmonary manifestations, which can be considered of limited clinical threat in Japan where the resistant rate has currently decreased, is discussed on the basis of unique biological characteristics of M. pneumoniae, the smallest self-replicating organism.
Collapse
Affiliation(s)
- Mitsuo Narita
- Department of Pediatrics, Sapporo Tokushukai Hospital Sapporo, Japan
| |
Collapse
|
9
|
Mycoplasma pneumoniae as a trigger for Henoch-Schönlein purpura in children. Cent Eur J Immunol 2016; 40:489-92. [PMID: 26862316 PMCID: PMC4737748 DOI: 10.5114/ceji.2015.56976] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 11/13/2015] [Indexed: 01/13/2023] Open
Abstract
Mycoplasma pneumoniae is one of the most common causes of respiratory tract infections in children. Extrapulmonary manifestations are seen in up to 25% of infected patients. Extrapulmonary complications are associated with the central nervous system, gastrointestinal tract, skin changes, myocarditis, pericarditis, hemolytic anemia, thrombocytopenia and thrombosis. The majority of extrapulmonary symptoms are associated with skin changes such as exanthematous skin eruptions, erythema nodosum, urticaria, Stevens-Jonson syndrome. M. pneumoniae stimulates production of the interleukins and tumor necrosis factor (TNF) α and can cause vasculitis. Henoch-Schönlein purpura (HSP) is a leucoclastic vasculitis that affects small vessels. Clinical manifestations of HSP include typical rash, arthritis, gastrointestinal and sometimes renal involvement. The main feature in HSP is abnormal IgA deposits in vessel walls. Circulating abnormal glycosylated IgA 1 and IgG antibodies form immune complexes: IgA1-IgG and anti-IgA 1. Immune complexes activate cytokines, parts of complement and influence directly the endothelium. We report cases of three children with Henoch-Schönlein purpura with prolonged and recurrent skin and joint changes. The serological analysis (positive serum IgM) confirmed Mycoplasma pneumoniae infection. Treatment with clarithromycin caused complete regression of disease. We suggest that in the case of prolonged symptoms of vasculitis due to Henoch-Schönlein purpura, Mycoplasma pneumonia infection may be a potential cause of exacerbation of the disease.
Collapse
|
10
|
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
|
11
|
Greco F, Catania R, Pira AL, Saporito M, Scalora L, Aguglia MG, Smilari P, Sorge G. Erythema Nodosum and Mycoplasma pneumoniae Infections in Childhood: Further Observations in Two Patients and a Literature Review. J Clin Med Res 2015; 7:274-7. [PMID: 25699127 PMCID: PMC4330023 DOI: 10.14740/jocmr2011w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2014] [Indexed: 11/11/2022] Open
Abstract
Erythema nodosum (EN) is the most frequent panniculitis in childhood and has been associated with various conditions, such as infectious and autoimmune disorders, medications, and malignancies. The author reports on two children affected with EN associated with Mycoplasma pneumoniae infection, which occurred in one patient without pulmonary detection. The available literature on EN and M. pneumoniae infection in childhood is also reviewed.
Collapse
Affiliation(s)
- Filippo Greco
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Roberta Catania
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Alice Le Pira
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Marco Saporito
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Luisa Scalora
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Maria Giovanna Aguglia
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Pierluigi Smilari
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| | - Giovanni Sorge
- Unit of Clinical Pediatrics, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy
| |
Collapse
|
12
|
Balamurugesan K, Viswanathan S. Henoch-Schonlein purpura presenting sequentially as nodular rash, erythema nodosum, and palpable purpura. J Family Community Med 2014; 21:58-60. [PMID: 24696039 PMCID: PMC3966098 DOI: 10.4103/2230-8229.128788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We describe a 26-year-old woman who presented with a nodular rash on the elbows following an insect bite. Two days later, she developed erythema nodosum. Both these lesions were treated symptomatically. One week later, she had purpura, abdominal pain, hematuria, and arthralgias, following which steroids were administered. Her investigations revealed only microscopic hematuria that disappeared with therapy. This pattern of sequential appearance of rash and a nodular morphology are both unique features not previously reported.
Collapse
Affiliation(s)
- Kandan Balamurugesan
- Department of General Medicine, Indira Gandhi Medical College, Kathirkamam, Pondicherry, India
| | - Stalin Viswanathan
- Department of General Medicine, Indira Gandhi Medical College, Kathirkamam, Pondicherry, India
| |
Collapse
|
13
|
Di Lernia V. Mycoplasma pneumoniae: an aetiological agent of acute haemorrhagic oedema of infancy. Australas J Dermatol 2013; 55:e69-70. [PMID: 23574367 DOI: 10.1111/ajd.12047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 01/30/2013] [Indexed: 11/29/2022]
Abstract
Acute haemorrhagic oedema of infancy (AHEI) is considered a separate clinical entity among cutaneous small vessel vasculitis of childhood. It usually occurs in children younger than 2 years of age, with spontaneous recovery occurring within a few weeks. A history of recent upper respiratory or urinary tract infections or immunisation is found in most patients. Although Mycoplasma pneumoniae has been linked to a wide array of skin eruptions or diseases, it is not recognised as a possible cause of acute haemorrhagic oedema of infancy. The authors report a child with AHEI and a concurrent M. pneumoniae infection.
Collapse
Affiliation(s)
- Vito Di Lernia
- Unit of Dermatology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| |
Collapse
|