{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:00:55Z","timestamp":1791896455355,"version":"4.3.4"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T00:00:00Z","timestamp":1586476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>A new concept has come to light recently, that is, Mycoplasma-induced rash and mucositis (MIRM). Here, we report the first case of recurrent rash, mucositis, and conjunctivitis involving Mycoplasma pneumoniae and C. pneumoniae that fits under the criteria of what is currently defined as MIRM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case Presentation<\/jats:title>\n                  <jats:p>A patient aged 12 years with a history of recurrent aphthous ulcers presented in 2013 with worsening oral lesions, conjunctivitis, and vesicular rash. Her respiratory polymerase chain reaction (PCR) panel was positive for M. pneumoniae. She was diagnosed with Stevens-Johnson syndrome (SJS) secondary to M. pneumoniae and treated with a macrolide, acyclovir, and intravenous immunoglobulin (IVIG). The same patient returned 3 years later with an identical constellation of symptoms, at which time her PCR was positive for C. pneumoniae. In addition to IVIG and a macrolide, a corticosteroid treatment was administered.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Here, we present the case of a pediatric patient with a recurrence of mucocutaneous disease that is more consistent with MIRM than the proposed SJS or erythema multiforme (EM) documented via histology. Our patient\u2019s symptoms were controlled with azithromycin and IVIG and, in the second episode, with corticosteroids as well. This case adds to that of Mayor-Ibarguren et al, providing further evidence that C. pneumonia may also be a trigger for MIRM. Patients will benefit from expanding the definition of MIRM, as the pathogenesis differs from SJS and EM and could result in more specific treatment options.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piaa028","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T20:23:04Z","timestamp":1584130984000},"page":"220-224","source":"Crossref","is-referenced-by-count":15,"title":["Rash and Mucositis Associated With <i>Mycoplasma pneumoniae<\/i> and <i>Chlamydophila pneumoniae<\/i>: A Recurrence of MIRM?"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6178-3895","authenticated-orcid":false,"given":"Danielle","family":"Brazel","sequence":"first","affiliation":[{"name":"Loyola Stritch School of Medicine, Maywood, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Kulp","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoanna","family":"Bautista","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bonwit","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,10]]},"reference":[{"key":"2021032616062713100_CIT0001","doi-asserted-by":"crossref","first-page":"245.e4","DOI":"10.1016\/j.jaad.2014.06.026","article-title":"Mycoplasma pneumoniae\u2013induced rash and mucositis as a syndrome distinct from Stevens-Johnson syndrome and erythema multiforme: a systematic review","volume":"72","author":"Canavan","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"2021032616062713100_CIT0002","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/pde.13140","article-title":"Mucositis secondary to Chlamydia pneumoniae infection: expanding the Mycoplasma pneumoniae\u2013induced rash and mucositis concept","volume":"34","author":"Mayor-Ibarguren","year":"2017","journal-title":"Pediatr Dermatol"},{"key":"2021032616062713100_CIT0003","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1172\/JCI93349","article-title":"Randomized, controlled trial of TNF-\u03b1 antagonist in CTL-mediated severe cutaneous adverse reactions","volume":"128","author":"Wang","year":"2018","journal-title":"J Clin Invest"},{"key":"2021032616062713100_CIT0004","doi-asserted-by":"crossref","first-page":"e386","DOI":"10.1542\/peds.2015-0278","article-title":"Outbreak of Mycoplasma pneumoniae-associated Stevens-Johnson syndrome","volume":"136","author":"Olson","year":"2015","journal-title":"Pediatrics"},{"key":"2021032616062713100_CIT0005","doi-asserted-by":"crossref","first-page":"e238","DOI":"10.1111\/j.1651-2227.2011.02342.x","article-title":"Severe Mycoplasma pneumoniae-associated mucositis treated with immunoglobulins","volume":"100","author":"Bressan","year":"2011","journal-title":"Acta Paediatr"},{"key":"2021032616062713100_CIT0006","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jaip.2017.11.023","article-title":"SJS\/TEN 2017: building multidisciplinary networks to drive science and translation","volume":"6","author":"White","year":"2018","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2021032616062713100_CIT0007","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1001\/jamadermatol.2016.5668","article-title":"Systemic immunomodulating therapies for Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis","volume":"153","author":"Zimmermann","year":"2017","journal-title":"JAMA Dermatol"},{"key":"2021032616062713100_CIT0008","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s12016-017-8667-7","article-title":"Current perspectives on erythema multiforme","volume":"54","author":"Lerch","year":"2018","journal-title":"Clin Rev Allergy Immunol"}],"container-title":["Journal of the Pediatric Infectious Diseases 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