Thread by @guerreroespejo

A 19-YO👩‍🦰, taken care of an 11-YO👦with bronchitis: cough, fever, dyspnea & pneumonia (XR)
Levofloxacin➡️hypoxia resolved, but:
- Orolabial blisters & rash, day 8
- Conjunctivitis, day 9
- Hemorrhagic denuded labial lesions, day 17
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doi.org/10.1093/cid/ci…… #IDtwitter #MedEd

🔬skin lesion: interface dermatitis, consistent with erythema multiforme/Stevens-Johnson syndrome–type histological changes
ELISA for M. pneumoniae IgM, initially➖, &➕at day 10

MYCOPLASMA PNEUMONIAE-INDUCED RASH AND MUCOSITIS (MIRM)
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doi.org/10.1093/cid/ci…
#dermatology

Extrapulmonary manifestations of M. pneumoniae infection:
✔️in 10% of patients
✔️mucocutaneous eruptions, central nervous system disease, carditis, hemolytic anemia, and Raynaud disease associated with cold agglutinins, renal disease, or arthritis.

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#MedTwitter #Doctor

Mycoplasma pneumoniae, when associated with mucositis alone, has previously been labeled as Stevens–Johnson syndrome without cutaneous involvement or M. pneumoniae–associated mucositis or Fuchs syndrome
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#MedStudentTwitter #MedicalStudents

MIRM can present as severe mucositis alone, or mucositis with skin involvement.

Mucosal lesions tend to occur predominantly on the oral mucosa (1) followed by the ocular mucosa (2) and urogenital mucosa.
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#resident #medicine

The severity, etiologic agents, and features of MIRM distinguish it from erythema multiforme major, Stevens–Johnson syndrome, and toxic epidermal necrolysis.

MIRM: predominant mucosal involvement with variable cutaneous involvement
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#dermatologia #emergency

Systemic corticosteroids may suppress the inflammatory and immune response that is postulated to be the etiology of the mucositis.

Their use must be weighed in the context of severity of illness and the risk of secondary infection through the denuded mucosa.
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#microbiology