Cool Daniel, Nguyen Vivien, Zhang Susan, Seo Shiney, Dai Shuan
Ophthalmology Department, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Faculty of Medicine, University of Queensland, Australia.
J Paediatr Child Health. 2025 Aug;61(8):1263-1269. doi: 10.1111/jpc.70103. Epub 2025 Jun 5.
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.
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.
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.
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.
肺炎支原体感染有所增加。这可能伴有肺外表现，包括支原体诱导的皮疹和粘膜炎（MIRM）。本文旨在描述澳大利亚昆士兰州一家儿科三级转诊医院中MIRM的眼部特征，并回顾这些患者的治疗及预后情况。
本研究纳入了14例就诊于昆士兰儿童医院的患者病例系列。通过回顾性病历审查获取患者的人口统计学资料、眼部检查结果及治疗方法。
患者平均年龄为11.2岁（范围8 - 15岁），男性居多（73%）。所有患者均有结膜充血或溃疡。无患者出现角膜受累情况。1例患者单眼接受了羊膜移植及胶水睑裂缝合术。其他所有患者采用保守治疗，谨慎使用局部类固醇药物，并接受多学科护理。大多数患者（80%）完全康复，未形成睑球粘连或穹窿缩短。
对于MIRM患者，应考虑使用无防腐剂抗生素和润滑剂进行保守治疗作为初始一线治疗方法。局部皮质类固醇治疗应由眼科服务指导。这应与全身治疗及针对眼外并发症的多学科护理相结合。该病例系列为未来可能出现MIRM的患者提出了治疗指南。儿科和初级保健医生应了解MIRM的眼部特征，以便促进早期转诊至眼科医生处并接受干预，从而获得最佳预后。
