Background: Mucocutaneous eruptions are pathologies that affect mainly skin and mucous membranes. Based on clinical examinations and causes they can be categorized as erythema multiform (EMF), Stevens Johnson syndrome (SJS), drug reactions and Infectious causes of mucocutaneous eruptions. More appropriate broader term reactive infectious mucocutaneous eruption (RIME), which also includes Mycoplasma pneumoniae-induced rash and mucositis (MIRM), is among the recently recognized infectious cause in the published reports.

Case Presentation: This is 9-year-old male with cough and low grade fever of 8 days followed by skin rash involving the perioral region, back of trunk and tip of his penis of 3 days duration. Physical findings include: painful erosions/ulcers on the lips and oral mucosa with hemorrhagic crusts mainly on the upper lip and conjunctival hyperemia with sticky blepharitis. He had also maculopapular rash and atypical target lesions on the posterior trunk. Chest x-ray showed pneumonia and with suspected case of RIME he was admitted and treated with ceftriaxone, azithromycin, steroids and discharged improved after 8 days of ward stay.

Conclusion: We recommend that any case with mucocutaneous eruptions from LMIC with severe mucosal and discrete cutaneous involvements should be evaluated for possible RIME (early diagnosis and treatment is very important for the patient) due to limited availability of important investigations (serology and PCR).

Keywords: Eastern Part of Ethiopia; LMIC; Pediatric Dermatology; Infectious Disease; Reactive Infectious Mucocutaneous Eruption

Abbreviations

BSA: Body Surface Area; CBC: Complete Blood Count; CXR: Chest X-Ray; DEN: Drug-Induced Epidermal Necrolysis; EMF: Erythema Multiform; ECCM: Emergency and Critical Care; ESR: Erythrocyte Sedimentation Rate; HIV: Human Immunodeficiency Viruses; IV: Intravenous; LMIC: Low and Middle Income Countries; MIRM: Mycoplasma Induced Rash and Mucositis; MP: Mycoplasma pneumoniae; OPD: Outpatient Department; PCR: Polymerase Chain Reaction; RIME: Reactive Infectious Mucocutaneous Eruptions; SJS: Steven Johnson Syndrome; TEN: Toxic Epidermal Necrolysis; WBC: White Blood Cells

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