title: Stevens-Johnson syndrome in a boy with macrolide-resistant Mycoplasma pneumoniae pneumonia.
abstract: Mycoplasma pneumoniae is a highly specialized parasitic bacterium that is a significant cause of community-acquired pneumonia in children. Although most such respiratory infections are mild, a minor percentage of patients require hospitalization and, occasionally, intensive treatment for respiratory failure. A variety of extrapulmonary sequelae of M pneumoniae infections have been described, including Stevens-Johnson syndrome. Macrolide resistance in M pneumoniae has developed rapidly in Asia, particularly in China, over the past decade and is now appearing in the United States. Emerging resistance to macrolides creates a therapeutic conundrum, particularly for pediatricians caring for young children in whom absolute or relative contraindications exist for the use of tetracyclines or fluoroquinolones, the 2 other main classes of drugs shown to be efficacious for M pneumoniae. We describe here the case of a child with a prolonged febrile illness associated with Stevens-Johnson-like mucocutaneous involvement who was found to have a respiratory infection with macrolide-resistant M pneumoniae.
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA. patkinson@peds.uab.edu
authors.forename: T Prescott
authors.initials: TP
authors.lastname: Atkinson
authors.forename: Suresh
authors.initials: S
authors.lastname: Boppana
authors.forename: Amy
authors.initials: A
authors.lastname: Theos
authors.forename: L Scott
authors.initials: LS
authors.lastname: Clements
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.forename: Ken
authors.initials: K
authors.lastname: Waites
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D004352:Drug Resistance, Microbial; D005500:Follow-Up Studies; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000209:etiology*
chemical_list: D018942:Macrolides