To evaluate the natural history and ophthalmologic morbidity of Mycoplasma pneumoniae induced rash and mucositis (MIRM) and propose a treatment algorithm.
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.
There were 15 patients (10 male and 5 female) aged 10.9 +/- 4.2 years who had primary episodes of MIRM and of those, 4 had multiple episodes. All patients required topical steroid treatment, 3 required amniotic membrane transplantation and one patient underwent placement of Prokera Classic device (Biotissue, Miami FL). There were no patients who suffered visual loss but 1 was left with mild symblepharon near the lateral canthus in each eye and 2 others had scarring of the eyelid margins and blepharitis.
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.

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References

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