Reactive infectious mucocutaneous eruption (RIME) – A new face of a known entity

Abstract

Reactive infectious mucocutaneous eruption (RIME) is a serious adverse mucocutaneous reaction that occurs primarily in children and adolescents after a viral or bacterial infection most commonly caused by Mycoplasma pneumoniae (formerly known as Mycoplasma-induced rash and mucositis [MIRM]). Although MIRM was first described as a new entity in 2015, recent updates to its nomenclature have expanded its scope to include other bacteria and viruses that can cause similar mucocutaneous reactions. While the case presented here involves a mucocutaneous reaction in response to a Mycoplasma infection, the updated nomenclature highlights the importance of recognizing and understanding this condition to better integrate it into the diagnosis of future mucocutaneous reactions.

We present the case of a 16-year-old male adolescent who was admitted to the hospital with bilateral phlegmon, aphthous stomatitis, glossitis, bilateral conjunctivitis and papules on both foot soles. He had had a 10-day history of an airway infection, characterized by fever and cough. Diagnostic tests revealed elevated infectious markers and positive serologies for Mycoplasma pneumoniae. Based on these findings, the patient was admitted to the Pediatric Ward and diagnosed with RIME. He was treated with ceftriaxone, azithromycin, methylprednisolone, ocular ofloxacin, and a mucositis solution. The patient remained hospitalized for 7 days and showed progressive improvement, with complete resolution of symptoms after 4 weeks.

Through this case, we aim to highlight the signs and symptoms of RIME, which can help ensure timely diagnosis and appropriate management of new cases.