Mycoplasma pneumoniae is a common cause of upper respiratory infection in the pediatric population. Up to 94% of the Mycoplasma-associated infections may produce extrapulmonary manifestations that most commonly involve the mucous membranes (94% oral, 82% ocular, and 63% urogenital mucositis).

The term Mycoplasma-induced rash and mucositis (MIRM) was first introduced by Canavan et al in 2015 as a distinct clinical entity to differentiate it from other causes of infectious or medication-related mucocutaneous lesions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).

MIRM and SJS/TEN can have similar clinical presentations, namely mucocutaneous eruptions involving the ocular, oral, and genitourinary mucosal surfaces.

However, MIRM differs from SJS/TEN in that the former is more commonly seen in children (mean age: 11.9; 66% male) and is associated with mucositis alone, or prominent mucositis with minimal cutaneous involvement.

When the skin is involved, the rash in MIRM is typically sparse and is characterized by vesiculobullous or targetoid cutaneous lesions.

In contrast, SJS/TEN often present in adults (mean age: 47.1; 66% female) with large, widespread, purpuric, coalescing bullous lesions that progress to sloughing and necrosis.

Initially, our patient’s Mycoplasma antibody testing was negative. This could be secondary to the temporal profile of disease process, because Mycoplasma IgM is typically produced within a week of initial infection and peaks at 3 to 6 weeks.

The patient’s otherwise negative infectious workup along with the atypical oculomucocutaneous findings warranted a repeat infectious laboratory at 1 week into hospitalization, which yielded highly positive Mycoplasma pneumoniae IgG and IgM titers.

Of the reported cases of MIRM in the literature, the mean age of presentation was 21.4 years (range 8-46), and all had conjunctival involvement without corneal involvement except for the 1 patient reported by Santos et al.

Santos et al treated the patient with ocular occlusion, topic oxytetracycline ointment, and intravenous immunoglobulins at a dosage of 1 g/kg/d for 3 days with rapid improvement.

None of the reported cases required amniotic membrane transplant and all recovered without ocular sequelae except for 1 with eyelid margin scar affecting the meibomian glands.

Journal of Clinical and Experimental Ophthalmology is now accepting submissions on this topic. A standard EDITORIAL TRACKING SYSTEM is utilized for manuscript submission, review, editorial processing and tracking which can be securely accessed by the authors, reviewers and editors for monitoring and tracking the article processing. Manuscripts can be uploaded online at Editorial Tracking System (https://www.longdom.org/clinical-experimental-ophthalmology.html) or forwarded to the Editorial Office at manuscripts@longdom.org

Regards,

Lina Gilbert

Managing Editor

Pancreatic disorders and Therapy