Mycoplasma Pneumoniae-Induced Rash and Mucositis (MIRM)

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    Abstract

    A patient presented to BPEI ED with dysuria x4 days and worsening red eye and irritation OU x2 days. Diagnosed with possible STI + conjunctivitis by outside Urgent Care 2 days prior. On our examination, he had decreased BCVA of 20/50 OD and 20/30 OS, 2+ conjunctival injection, and white discharge. He was treated initially for presumed gonoccocal conjunctivitis. Two days later, he developed worsening eye pain and discharge with new oral ulcers and new atypical targetoid skin rash on his hands. The patient was admitted to UMH. Laboratory workup revealed positive Mycoplasma pneumoniae IgG, and he was diagnosed with Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Inpatient ophthalmic examination revealed membranous conjunctivitis with conjunctival and corneal epithelial defects. The patient underwent bedside sutureless amniotic membrane transplantation OU. At POM#1 follow-up, he had recovered to baseline with BCVA 20/20 OU, no conjunctival injection, and no ocular surface staining.
    

    
    

    Presentation Date: 05/06/2021

    Issue Date: 05/21/2021
    

    
    
  • Presenter: Neel D. Pasricha, MD URL
  • Faculty Discussant: Guillermo Amescua, MD URL
  •     Contributor: Swapna Shanbhag, MD