Mycoplasma pneumoniae-induced rash and mucositis

Mycoplasma pneumoniae-induced rash and mucositis is a rare, immune-mediated condition characterised by mucosal inflammation with limited cutaneous involvement. It is increasingly recognised as a distinct clinical entity, separate from erythema multiforme and Stevens-Johnson syndrome.

A young man presented with fever and cough, followed by red, irritated eyes and painful ulcerations of the lips, oral mucosa and genitals. Polymerase chain reaction (PCR) testing of a nasopharyngeal sample confirmed Mycoplasma pneumoniae infection. Dermatologic examination revealed mucositis without cutaneous involvement, and ophthalmologic examination showed bilateral conjunctivitis. A diagnosis of Mycoplasma pneumoniae-induced rash and mucositis was made. Treatment with doxycycline and systemic corticosteroids led to symptom resolution without sequelae.

Mycoplasma pneumoniae-induced rash and mucositis should be considered in patients with mucositis and a preceding M. pneumoniae infection. However, similar reactive infectious mucocutaneous eruptions can also occur with other bacterial or viral respiratory infections in children. Distinguishing reactive infectious mucocutaneous eruptions like Mycoplasma pneumoniae-induced rash and mucositis from erythema multiforme and Stevens-Johnson syndrome is crucial, as the former requires different management and has a more favourable prognosis.