{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:19:10Z","timestamp":1780391950181,"version":"3.54.1"},"reference-count":37,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Background: Reactive Infectious Mucocutaneous Eruption (RIME) is a mucositis-predominant syndrome that usually follows respiratory infections in children. Although Mycoplasma pneumoniae is a well-established trigger, viral pathogens as triggers\u2014especially SARS-CoV-2\u2014have been increasingly reported. RIME is often misclassified as Stevens\u2013Johnson syndrome (SJS), which may lead to inappropriate management. Case Presentation: We describe a 12-year-old previously healthy boy who presented with fever, dry cough, odynophagia, and vomiting for 9 days. On admission, he had severe oral ulcerations, bilateral conjunctivitis, and a non-blanching maculopapular rash. Laboratory tests confirmed co-infection with M. pneumoniae and SARS-CoV-2. Inflammatory markers were mildly elevated. Notably, the patient also developed asymptomatic sinus bradycardia, with no signs of structural heart disease. He was treated with antibiotics, intravenous corticosteroids, and supportive care. His mucosal symptoms improved rapidly, and he was discharged in stable condition on day 7. Follow-up at 12 days showed near-complete resolution of all lesions. Conclusions: This case illustrates several clinically relevant features. First, it highlights a dual infectious trigger\u2014M. pneumoniae and SARS-CoV-2\u2014that may have contributed to a more severe mucosal reaction. Second, the patient developed transient sinus bradycardia without myocardial involvement, suggesting a possible inflammatory autonomic response, rarely reported in RIME. Finally, this case supports the early use of corticosteroids in severe mucosal disease, with good outcomes and no complications. Prompt recognition of RIME, especially in the context of viral\u2013bacterial coinfection, is essential to avoid misdiagnosis and to guide appropriate, multidisciplinary management.<\/jats:p>","DOI":"10.3390\/idr17050121","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T07:46:49Z","timestamp":1758786409000},"page":"121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["More than Mucositis: Pediatric RIME Following Co-Infection with SARS-CoV-2 and Mycoplasma pneumoniae\u2014A Case Report and Mini-Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9040-218X","authenticated-orcid":false,"given":"Alina Corina","family":"Grama","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 38 Gheorghe Marinescu, 540142 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Pediatrics, Emergency County Clinical Hospital of T\u00e2rgu Mure\u0219, 50 Gheorghe Marinescu, 540136 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Grama","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology 2, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 38 Gheorghe Marinescu, 540142 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7476-2821","authenticated-orcid":false,"given":"M\u0103riuca","family":"M\u0103nescu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emergency County Clinical Hospital of T\u00e2rgu Mure\u0219, 50 Gheorghe Marinescu, 540136 T\u00e2rgu Mure\u0219, Romania"},{"name":"Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 38 Gheorghe Marinescu, 540142 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Chince\u0219an","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 38 Gheorghe Marinescu, 540142 T\u00e2rgu Mure\u0219, Romania"},{"name":"Department of Pediatrics, Emergency County Clinical Hospital of T\u00e2rgu Mure\u0219, 50 Gheorghe Marinescu, 540136 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.tim.2013.01.003","article-title":"Mycoplasmas and their host: Emerging and re-emerging minimal pathogens","volume":"21","author":"Citti","year":"2013","journal-title":"Trends Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Parrott, G.L., Kinjo, T., and Fujita, J. 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