Mycoplasma pneumoniae infection-induced

To describe a case of Stevens-Johnson syndrome associated with Mycoplasma infection and demonstrate how early detection and diagnosis can produce a favourable outcome. MYCOPLASMA PNEUMONIAE • A well known childhood pathogen1 • A prokaryote ⇒ lacks a cell wall1 – cannot be Gram-stained – not susceptible to antibiotics which affect cell walls such as beta-lactams – susceptible to antibiotics that interfere with protein or DNA synthesis such as tetracyclines, macrolides and quinolones • Serology the most common method of diagnosis2 • Is primarily a respiratory pathogen, but can cause extrapulmonary disease (for example: skin, gastrointestinal, cardiovascular, renal)3 STEVENS-JOHNSON SYNDROME • Characterised by mucous membrane erosions and widespread blisters, often predominant on the chest and presenting with erythematous and purpuric macules4 • Extent of skin involvement variable5 • Systemic symptoms are common and can include high fever and malaise6 • Most commonly associated with drug reactions, but can be triggered by infections such as Herpes or Mycoplasma4 • Treatment is supportive and symptomatic, and should include skin and mucous membrane care7 Clinical features in this case • JH, 6 year old boy, previously well • No known medical history or allergies • No regular medications • 12 days history of respiratory symptoms – cough, fever – unsuccessful treatment with oral amoxicillin • Two days history of rash and painful mouth ulcers ON EXAMINATION: • miserable • exudative conjunctivitis • several oral ulcerations • erythema multiforme • cervical lymphadenopathy DIAGNOSIS: Stevens-Johnson syndrome (possibly infection induced