Mycoplasma pneumoniae Induced Rash and Mucositis MIRM StatPearls NCBI Bookshelf

When present, the cutaneous rash in MIRM displays distinct features compared to other mucocutaneous eruptions. Such information can provide valuable clues aiding in the differentiation of MIRM from other mucocutaneous eruptions, such as erythema multiforme and SJS/TEN. Proposed mechanisms include immune activation, resulting in polyclonal B-cell and antibody production, leading to immune complex deposition and complement activation, subsequently causing skin lesions. In the systematic review by Canavan et al, 60% of the identified cases of MIRM occurred in males, with 47% of patients experiencing mucositis without significant skin involvement and 34% presenting with mucositis alone without any skin involvement. Mucocutaneous eruptions, characterized by rashes affecting both mucous membrane and skin, have varied inciting etiologies, including infectious, frequently viral, drug-induced reactions, and autoimmune factors.

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Aside from respiratory manifestations, M pneumoniae causes extrapulmonary syndromes, affecting approximately 25% of patients. Aside from respiratory manifestations, M pneumoniae causes extrapulmonary syndromes, affecting approximately 25% of patients. Check out CoinMarketCap Alexandria’s guide on the top cold wallets of 2021 and top hot wallets of 2021. Hot wallets are able to be connected to the web, while cold wallets are used for keeping large amounts of coins outside of the internet.

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Although the transmission patterns of MIRM are not well-established, it is advisable for patients and close contacts of suspected M pneumoniae pulmonary infection to implement basic infection control measures, including droplet transmission precautions. In addition, it is important to keep cutaneous lesions as clean as possible to prevent secondary bacterial infection. Patients diagnosed with MIRM should be informed about the potential for painful mucosal lesions, which can lead to dehydration and limit oral nutrient intake.

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Additionally, obtaining consultations with otolaryngologists, ophthalmologists, gastroenterologists, and urologists may be helpful for site-dependent mucosal lesions to mitigate long-term sequelae. Although 81% of patients with MIRM experience a full recovery, there are potential long-term sequelae, mostly involving the mucosa. Only 4% of patients required admission to intensive care, with 81% experiencing complete recovery. In a more recent systematic review by Lofgren and Lenkeit, 77% of patients received antibiotics, 37% were treated with corticosteroids, and 11% received IVIG. In a study by Canavan et al, 35% of patients received systemic corticosteroids, and 8% received IVIG. In addition, lesions in particular mucosal areas may warrant specialty consultation with ophthalmology, otolaryngology, gastroenterology, and urology to mitigate long-term complications.

• MIRM, a recently identified mucocutaneous entity, was introduced and coined in a 2015 systematic review by Canavan et al.
• This medication history may sometimes lead to a lower index of suspicion for infection during differential diagnosis evaluation (see Image. Mycoplasma pneumoniae–Induced Rash and Mucositis).
• Notably, mucocutaneous manifestations occur in approximately 25% of patients with M pneumonia infections.
• Within MIRM, 3 types differ in their cutaneous, non-mucosal rash patterns
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• In contrast, patients afflicted with SJS/TEN often necessitate intensive care more frequently and face higher mortality rates.

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Mycoplasma pneumoniae

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• Skin detachment ranging from 10% to 30% overlaps between SJS and TEN, whereas skin detachment exceeding 30% meets the criteria for TEN.
• Aside from respiratory manifestations, M pneumoniae causes extrapulmonary syndromes, affecting approximately 25% of patients.
• Rzany et al investigated specimens from erythema multiforme, SJS, and TEN and did not observe significant, consistent histologic distinctions.
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• As of 2020, the block reward has been halved three times and comprises 6.25 bitcoins.
• Ocular mucosal damage occurs in 8.9% of patients with MIRM, resulting in conjunctival shrinkage, corneal ulcerations, blindness, ocular synechiae, and loss of eyelashes.
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