Epstein-Barr Virus/Cytomegalovirus-Associated Erythema Multiforme in a Pediatric Patient

Area of Science:

• Immunology
• Infectious Diseases
• Dermatology

Background:

• Erythema multiforme (EM) is an immune-mediated mucocutaneous condition often triggered by infections or medications.
• Pediatric cases of EM commonly involve oral mucosa, with herpes simplex virus being a frequent precursor.
• While Epstein-Barr virus (EBV) and cytomegalovirus (CMV) have been individually linked to EM, co-infection is rarely reported.

Purpose of the Study:

• To report a novel case of erythema multiforme (EM) associated with concurrent Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection in a pediatric patient.
• To highlight the diagnostic challenges and successful management of this rare presentation.

Main Methods:

• A case study of a 10-year-old girl with mucocutaneous lesions was conducted.
• Initial suspicion of local anesthetic reaction was investigated through serological analysis.
• Diagnosis was confirmed by identifying primary acute EBV and CMV infection.

Main Results:

• The patient presented with perioral skin and oral mucosal ulcers and vesicles.
• Serological tests confirmed a dual primary infection with EBV and CMV.
• Lesions resolved completely within two weeks following antiviral and steroid therapy.

Conclusions:

• This case represents the first reported instance of erythema multiforme (EM) associated with concurrent Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection.
• The findings underscore the importance of considering viral etiologies, including rare co-infections, in pediatric EM cases.
• Effective management involves prompt diagnosis and supportive antiviral and anti-inflammatory treatment.