Stevens-Johnson Syndrome / Mycoplasma Induced Rash and Mucositis
A patient with history of bipolar disorder, recently started on Lamotrigine, presented with acute onset of malaise and a rapidly expanding vesiculobullous eruption over the past 24 hours. Lesions involved the face, oral mucosa, chest, genitals, extremities, and trunk. Associated symptoms included fever, tachycardia, and periorbital swelling. On examination, the patient was noted to have eyelid erythema and edema with associated conjunctival injection and temporal conjunctival epithelial defects with punctate epithelial erosions in bilateral corneas. Patient was diagnosed with Stevens-Johnsons syndrome and was started on IVIG, systemic corticosteroids, topical steroids, antibiotic, cyclosporine and amniotic membrane rings were placed in both eyes. Serology then demonstrated increased IgM for M.pneumoniae which increased suspicion for Mycoplasma Induced Rash and Mucositis (MIRM). It was then postulated that this patient could have a combination of both disease processes that could be potentiating each other and causing immune dysregulation. Aggressive topical treatment and placement of amniotic membrane rings/amniotic membranes was completed. The patient had a successful hospital course and was discharged with amniotic membranes in place with no evidence of epithelial defects on either eye.
Presentation Date: 09/18/2025
Issue Date: 12/05/2025
Please log in or click on ENROLL ME to access this course.
