- In children with Mycoplasma pneumoniae community-acquired pneumonia (CAP), mucocutaneous disease is common and associated with worse long-term outcomes.
- Findings suggest the need for caution in saddling children with a lifelong label of “medication allergy” and support an assumption of M pneumoniae CAP in mucocutaneous disease presentations.
Why this matters
- Editorial: These findings can guide intermediate- and long-term management, including surveilling for sequelae and precluding an incorrect labeling of severe medication allergy.
- 22.7% of the 44 children who were PCR-positive for M pneumoniae developed mucocutaneous lesions.
- 100% of that group tested positive for specific IgM-secreting cells.
- Skin manifestations included rash, mucositis, itching, maculopapular skin eruptions.
- In 2 patients, ocular symptoms were the only feature.
- In 3 cases of PCR-negative M pneumoniae CAP, mucocutaneous skin manifestations were also detected.
- Vs non-M pneumoniae CAP, with M pneumoniae positivity, the children had:
- Longer prodromal fever (P=.02).
- Higher C-reactive protein levels (P=.04).
- Greater likelihood of needing oxygen: OR, 17.6 (95% CI, 1.5-984.1; P=.007).
- Increased hospitalization: OR, 9.0 (95% CI, 1.4-81.4; P=.01).
- Greater rates of long-term sequelae (30% vs 0%; P=.03).
- Prospective, longitudinal cohort study in Zurich, 152 children ages 3-18 (median, 5.7) years, enrolled from May 1, 2016 to April 30, 2017.
- Funding: Not specified.
- Bias toward severe disease possible in a tertiary care center.
- Small numbers.