Mycoplasma-Induced Rash and Mucositis: Ocular Manifestations, Treatment and Outcomes in a Paediatric Population.

Background: There has been an increase in Mycoplasma pneumoniae infections. This can present with extra-pulmonary manifestations including mycoplasma-induced rash and mucositis (MIRM). This paper aims to describe the ocular features in MIRM at a paediatric tertiary referral hospital in Queensland, Australia, and review the treatment and outcomes of these patients.

Methods: A case series of 14 patients presenting to the Queensland Children's Hospital was included in this study. Patient demographics, ocular examination findings, and treatment methods were obtained from retrospective chart review.

Results: The mean age was 11.2 years (range 8-15 years) and was mostly male (73%). All patients had conjunctival injection or ulceration. No patients had corneal involvement. One patient underwent amniotic membrane graft and glue tarsorrhaphy for one eye. All others were managed non-surgically with cautious use of topical steroid, as well as multidisciplinary care. Most patients (80%) achieved full recovery with no symblepharon formation or forniceal shortening.

Conclusion: Conservative management with preservative-free antibiotics and lubricants should be considered as initial first-line treatment for patients presenting with MIRM. Topical corticosteroid therapy should be guided by an ophthalmology service. This should be in conjunction with systemic therapy and multidisciplinary care for extra-ocular complications. This case series suggests a treatment guideline for future patients presenting with possible MIRM. Paediatric and primary care physicians should be aware of ocular features of MIRM to facilitate early referral to and intervention by ophthalmologists to allow for the best outcome.