SHM Converge Scientific Abstract ePoster Gallery-A "Crime" on Esophagus

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This case report describes reactive infectious mucocutaneous eruption (RIME), a rare post-infectious inflammatory condition most often linked to Mycoplasma pneumoniae and typically seen in adolescents and young men. The authors present an unusual case in a 22-year-old woman with severe esophageal involvement.<br /><br />The patient had a history of recurrent sinusitis and was treated with multiple antibiotics over several weeks for presumed respiratory infections, but her symptoms progressed. She developed blurry vision, lip blisters, painful oral ulcers, vaginal lesions, hypoxia, shortness of breath, severe odynophagia, and dysphagia. On admission, she had bilateral conjunctivitis, periorbital erythema, oral mucosal erosions and swelling, and painful genital/perineal lesions. Imaging showed early pneumonia changes, and respiratory PCR was positive for Mycoplasma pneumoniae. Endoscopy revealed extensive superficial esophageal ulcers, including semi-circumferential and fully circumferential lesions; biopsy was avoided because of perforation risk.<br /><br />The report emphasizes that RIME can cause significant mucosal disease, including rare but severe esophageal involvement leading to painful swallowing and difficulty eating. Because RIME can be difficult to distinguish early from Stevens-Johnson syndrome or erythema multiforme, supportive inpatient care is the initial mainstay of management. In severe cases, intravenous steroids may be needed. This patient received one week of IV steroids, was discharged on an oral steroid taper and minced diet, and was referred for outpatient follow-up with gastroenterology, dermatology, and obstetrics/gynecology.<br /><br />The authors highlight the importance of early interdisciplinary evaluation to speed diagnosis and treatment. They also note that RIME may occur in adults, though it is usually seen in younger patients, and that its exact pathogenesis remains unclear.

Asset Subtitle

Anudeeksha Satheeshkumar

Meta Tag

Author List Anudeeksha Satheeshkumar, Cody Hu, Juan Echavarria, Priyadarshini Loganathan, Souleymane Diallo

Category Clinical Vignettes

Concept Reactive Infectious Mucocutaneous Eruption

Concept Swallowing Impairment

Concept Odynophagia

Concept Mycoplasma pneumoniae

Concept Mucositis

Distinguished Non-Finalist

Presenter Organization University of Texas Health Science Center at San Antonio

Presenting Author Anudeeksha Satheeshkumar

Track Adult

Keywords

reactive infectious mucocutaneous eruption

RIME

Mycoplasma pneumoniae

esophageal ulcers

mucosal erosions

odynophagia

dysphagia

conjunctivitis

Stevens-Johnson syndrome

intravenous steroids

Reactive Infectious Mucocutaneous Eruption

Swallowing Impairment

Odynophagia

Mycoplasma pneumoniae

Mucositis