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Outbreak of Mycoplasma pneumoniae-Associated Stevens-Johnson Syndrome.

Abstract：

BACKGROUND:Stevens-Johnson syndrome (SJS) is an uncommon, sporadic disease and outbreaks are rare. In November 2013, an outbreak of SJS was identified at Children's Hospital Colorado. METHODS:Outbreak cases were children aged 5-21 with a discharge diagnosis of SJS admitted from September 1 to November 30, 2013. Medical charts were reviewed using standardized data collection forms. Respiratory specimens were tested for viruses and Mycoplasma pneumoniae (Mp) by polymerase chain reaction (PCR). We conducted a separate 4-year retrospective case-control study comparing hospitalized SJS cases with and without evidence of Mp infection. RESULTS:During the outbreak, 8 children met SJS criteria. Median age was 11.5 years (range 8-16 years); 5 (63%) were boys and 5 (63%) were Mp-PCR-positive. Of the 5 PCR-positive children, none had preceding medication exposure, and all had radiographic pneumonia. All outbreak Mp isolates were macrolide susceptible. The retrospective case-control analysis showed that Mp-associated SJS episodes (n = 17) were more likely to have pneumonia (odds ratio [OR] 7.5, confidence interval [CI] 1.6–35.1), preceding respiratory symptoms (OR 30.0, CI 3.3–269.4) [corrected] an erythrocyte sedimentation rate ≥35 mg/dL (OR 22.8, CI 2.1-244.9), and ≤3 affected skin sites (OR 4.5, CI 1.2-17.4) than non-Mp-associated SJS episodes (n = 23). CONCLUSIONS:We report the largest outbreak of SJS in children, which was also predominately associated with Mp infection. Mp-associated SJS was associated with a distinct clinical presentation that included less extensive skin disease, an elevated erythrocyte sedimentation rate, and evidence of a preceding respiratory infection.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Olson D,Watkins LK,Demirjian A,Lin X,Robinson CC,Pretty K,Benitez AJ,Winchell JM,Diaz MH,Miller LA,Foo TA,Mason MD,Lauper UL,Kupfer O,Kennedy J,Glodé MP,Kutty PK,Dominguez SR

doi

10.1542/peds.2015-0278

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

e386-94

issue

2

eissn

0031-4005

issn

1098-4275

pii

peds.2015-0278

journal_volume

136

pub_type

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