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Mycoplasma Pneumoniae-Induced Rash and Mucositis: A Longitudinal Perspective and Proposed Management Criteria.
Am J Ophthalmol. 2020 11; 219:351-356.AJ

Abstract

PURPOSE

To evaluate the natural history and ophthalmologic morbidity of Mycoplasma pneumoniae-induced rash and mucositis (MIRM) and propose a treatment algorithm.

DESIGN

Retrospective, interventional case series.

METHODS

Retrospective chart review of all MIRM patients examined by the department of ophthalmology at a tertiary children's hospital. Diagnosis was established clinically concomitant with either positive Mycoplasma pneumoniae IgM or PCR testing from January 1, 2010, until December 31, 2019. The main outcome measures were best-corrected visual acuity, long-term ocular sequelae, and duration and type of ophthalmic intervention.

RESULTS

There were 15 patients (10 male and 5 female) aged 10.9 ± 4.2 years who had primary episodes of MIRM; of those, 4 had multiple episodes. All patients required topical steroid treatment, 3 required amniotic membrane transplantation, and 1 patient underwent placement of a sutureless biologic corneal badage device. There were no patients who suffered visual loss, but 1 was left with mild symblephara near the lateral canthus in each eye and 2 others had scarring of the eyelid margins and blepharitis.

CONCLUSIONS

The ocular morbidity is significantly less in MIRM than in other closely related syndromes such as erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. However, these patients still require close observation and a low threshold for intervention to avoid permanent ophthalmic sequelae and possible blindness.

Authors+Show Affiliations

Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA. Electronic address: Ryan.Gise@Childrens.Harvard.edu.Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32574770

Citation

Gise, Ryan, et al. "Mycoplasma Pneumoniae-Induced Rash and Mucositis: a Longitudinal Perspective and Proposed Management Criteria." American Journal of Ophthalmology, vol. 219, 2020, pp. 351-356.
Gise R, Elhusseiny AM, Scelfo C, et al. Mycoplasma Pneumoniae-Induced Rash and Mucositis: A Longitudinal Perspective and Proposed Management Criteria. Am J Ophthalmol. 2020;219:351-356.
Gise, R., Elhusseiny, A. M., Scelfo, C., & Mantagos, I. S. (2020). Mycoplasma Pneumoniae-Induced Rash and Mucositis: A Longitudinal Perspective and Proposed Management Criteria. American Journal of Ophthalmology, 219, 351-356. https://doi.org/10.1016/j.ajo.2020.06.010
Gise R, et al. Mycoplasma Pneumoniae-Induced Rash and Mucositis: a Longitudinal Perspective and Proposed Management Criteria. Am J Ophthalmol. 2020;219:351-356. PubMed PMID: 32574770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mycoplasma Pneumoniae-Induced Rash and Mucositis: A Longitudinal Perspective and Proposed Management Criteria. AU - Gise,Ryan, AU - Elhusseiny,Abdelrahman M, AU - Scelfo,Christina, AU - Mantagos,Iason S, Y1 - 2020/06/20/ PY - 2020/03/25/received PY - 2020/06/04/revised PY - 2020/06/04/accepted PY - 2020/6/24/pubmed PY - 2020/12/22/medline PY - 2020/6/24/entrez SP - 351 EP - 356 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 219 N2 - PURPOSE: To evaluate the natural history and ophthalmologic morbidity of Mycoplasma pneumoniae-induced rash and mucositis (MIRM) and propose a treatment algorithm. DESIGN: Retrospective, interventional case series. METHODS: Retrospective chart review of all MIRM patients examined by the department of ophthalmology at a tertiary children's hospital. Diagnosis was established clinically concomitant with either positive Mycoplasma pneumoniae IgM or PCR testing from January 1, 2010, until December 31, 2019. The main outcome measures were best-corrected visual acuity, long-term ocular sequelae, and duration and type of ophthalmic intervention. RESULTS: There were 15 patients (10 male and 5 female) aged 10.9 ± 4.2 years who had primary episodes of MIRM; of those, 4 had multiple episodes. All patients required topical steroid treatment, 3 required amniotic membrane transplantation, and 1 patient underwent placement of a sutureless biologic corneal badage device. There were no patients who suffered visual loss, but 1 was left with mild symblephara near the lateral canthus in each eye and 2 others had scarring of the eyelid margins and blepharitis. CONCLUSIONS: The ocular morbidity is significantly less in MIRM than in other closely related syndromes such as erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. However, these patients still require close observation and a low threshold for intervention to avoid permanent ophthalmic sequelae and possible blindness. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/32574770/Mycoplasma_Pneumoniae_Induced_Rash_and_Mucositis:_A_Longitudinal_Perspective_and_Proposed_Management_Criteria_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(20)30296-8 DB - PRIME DP - Unbound Medicine ER -