A case of toxic epidermal necrolysis in a paediatric patient with mycoplasma pneumoniae infection

Suha A. F. M. A. Sabry; G. Ravindi L. Perera; Aliaksandr Klachko; Nataliya Amelchanka; Uladzimir Serhiyenka; Aliaksandr Kozich; Chamodi A. Alwis Weerasinghe; Umaya Samaraweera; Keith W. Rathnaweera; Natallia Tsikhan

doi:10.18203/2320-6012.ijrms20253190

Authors

Suha A. F. M. A. Sabry Department of Pediatrics 1, Grodno State Medical University, Republic of Belarus
G. Ravindi L. Perera Department of Pediatrics 1, Grodno State Medical University, Republic of Belarus
Aliaksandr Klachko Grodno Regional Children’s Clinical Hospital, Republic of Belarus
Nataliya Amelchanka Grodno Regional Children’s Clinical Hospital, Republic of Belarus
Uladzimir Serhiyenka Department of Pediatrics 1, Grodno State Medical University, Republic of
Aliaksandr Kozich Grodno Regional Children’s Clinical Hospital, Republic of Belarus
Chamodi A. Alwis Weerasinghe Department of Pediatrics 1, Grodno State Medical University, Republic of Belarus
Umaya Samaraweera Department of Pediatrics 1, Grodno State Medical University, Republic of Belarus
Keith W. Rathnaweera Department of Pediatrics 1, Grodno State Medical University, Republic of Belarus
Natallia Tsikhan 1Department of Pediatrics 1, Grodno State Medical University, Republic of Belarus

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253190

Keywords:

Toxic epidermal necrolysis, Stevens-Johnson syndrome, Mycoplasma pneumoniae, Paediatrics, Body surface area, Critical care

Abstract

Toxic Epidermal Necrolysis (TEN) is a rare, life-endangering emergency condition with a high mortality rate. While medications are recognized as common trigger factors, infections like Mycoplasma pneumoniae are also increasingly being recognized as other potential triggers, particularly in the paediatric population. A 6-year-old boy presented with fever, sore throat and tender skin lesions that rapidly progressed from erythema, macular rash to multiple vesicles, flaccid bullae and erosion, affecting more than 70% of total body surface area. Epidermal necrolysis affects more than 30% of the total body surface area including genital, oral and conjunctival mucus membranes. A diagnosis of Toxic Epidermal Necrolysis was established. Laboratory tests confirmed Mycoplasma pneumoniae infection and a chest Х-ray revealed pneumonia. For management of TEN, IVIG, followed by Methylprednisolone pulses were in combination. This was combined with antibacterial therapy and supportive care. The patient made a complete recovery with no complications after 36 days under Intensive Care. This case underscores Mycoplasma pneumoniae as a paediatric TEN trigger. It also serves to highlight the efficacy of combined immunotherapy and multidisciplinary care and the importance of early intervention in minimizing complications, especially in such severe cases.

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