The New England Journal of MedicineImages in Clinical Medicine: Mycoplasma-Induced Rash and Mucositis

A Case Study Highlighting Diagnostic Challenges and Treatment Approaches

An 8-year-old girl presented with a range of symptoms including painful lip crusting, oral ulcers, rash, and genital pain, which were later diagnosed as mycoplasma-induced rash and mucositis. This case highlights the importance of recognizing this postinfection mucocutaneous syndrome, which can manifest similarly to the Stevens–Johnson syndrome but generally has a more favorable prognosis.

Key Points

• The patient had a 3-day history of painful lip crusting, oral ulcers, rash, and genital pain.
• She had developed a fever and cough 10 days before presentation.
• Physical examination revealed conjunctivitis in both eyes, ulcers in the oropharynx, scattered vesicular lesions across her face, and multiple small ulcers in the vulvar and perianal regions.
• A serum IgM antibody test and a sputum polymerase-chain-reaction test were positive for Mycoplasma pneumoniae.
• The diagnosis was mycoplasma-induced rash and mucositis, a postinfection mucocutaneous syndrome that can manifest similarly to the Stevens–Johnson syndrome.
• The patient was given supportive care and treatment with doxycycline for the pneumonia. Two weeks after presentation, the mucocutaneous lesions had abated, and the pneumonia symptoms resolved soon after.

According to a study published in Pediatric Dermatology, Mycoplasma pneumoniae is an important cause of skin rashes in children and adolescents.

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