Preview

CHILDREN INFECTIONS

Advanced search

The role of mixed Mycoplasma and Herpesvirus infections in case of skin lesions in children

https://doi.org/10.22627/2072-8107-2019-18-3-5-10

Abstract

Numerous literature data show the role of mycoplasma infection in the development of non-respiratory lesions of various organs and systems, including the skin. Herpesvirus and mycoplasma infections can trigger the development of immune-mediated inflammatory reactions of the skin and mucous membranes — erythema multiforme exudative, Stevens-Johnson syndrome, vesicular pustular dermatosis — Sneddon-Wilkinson syndrome, etc.

In order to study the frequency and nature of skin lesions with mycoplasmosis combined with herpesvirus infection, 45 patients aged 3 to 15 years of life were observed. A comprehensive clinical and laboratory study revealed skin lesions in 27 patients associated with current mycoplasma and herpesvirus infections. Thus, multiforme exudative erythema in the small form variant was diagnosed in 13 patients, skin vasculitis in 4, hemorrhagic purpura in 3, urticaria rash in 3, erythema nodosum in 2, mucositis in 2 children. In 18 children, a combined mycoplasma and herpesvirus infection was established. In 9 children, a mono infection was detected (in 5 — herpes virus and in 4 — mycoplasma).

All observed patients showed antibodies to smooth muscle antigens in titers from 1:80 to 1:160 (normal 1:40) and in the vast majority (in 24 patients) — antibodies to vascular endothelial antigens in titers from 1:80 to 1:320 (with the norm of 1:40). Compaction of the intima-media complex was detected in 6 patients with monoinfection and in 16 patients with co-infection, according to ultrasound duplex scanning of the vessels of the brachiocephalic department.

Thus, for various immuno-inflammatory, allergic skin diseases, screening for infections, in particular, mycoplasma and herpesvirus, is necessary to optimize treatment.

About the Authors

H. O. Kuvardina
Russian National Research Medical University named after N.I. Pirogov, Ministry of Health of the Russian Federation
Russian Federation


F. S. Kharlamova
Russian National Research Medical University named after N.I. Pirogov, Ministry of Health of the Russian Federation
Russian Federation

MD, Professor, Department of Infectious Diseases in Children 



I. V. Polesko
Russian National Research Medical University named after N.I. Pirogov, Ministry of Health of the Russian Federation
Russian Federation


O. V. Shamsheva
Russian National Research Medical University named after N.I. Pirogov, Ministry of Health of the Russian Federation
Russian Federation


O. S. Ostapuschenko
Multidisciplinary clinic «VESSEL CLINIC»
Russian Federation


References

1. Nilsson A.C., Bjоrkman P., Persson K. Polymerase chain reaction is superior to serology for the diagnosis of acute Mycoplasma pneumoniae infection and reveals a high rate of persistent infection. BMC Microbiology. 2008; 8:93. doi:10.1186/1471-2180-8-93.

2. Yamazaki T., Kenri T. Epidemiology of Mycoplasma pneumoniae infections in Japan and therapeutic strategies for macrolid resistant M. pneumonia. Front Microbiol. 2016; 23 (7): 693.

3. Ющук Н.Д., Огиенко О.Л. Микоплазмозы. М.: ГЭОТАР-Медиа, 2011:23. (в Национальном руководстве «Инфекционные болезни»). Yushchuk N.D., Ogienko O.L. Mycoplasmosis. M.: GEOTAR-Media, 2011: 23. (In Russ.)

4. Hoek K.L., Duffy L.B., Cassell G.H., Atkinson T.P. A role for the Mycoplasma pneumoniae adhesin P1 in Interleukin (IL)-4 synthesis and release from rodent mast cells. Microb Pathog. 2005; 39:149—158.

5. Попова Н.В., Деев И.Е., Петренко А.Г. Клатрин-зависимый эндоцитоз и белки-адаптеры. Acta Naturae. 2013. 3(48):66—77. Popova N.V., Deev I.E., Petrenko A.G. Clathrin-dependent endocytosis and adapter proteins. Acta Naturae. 2013. 3(48): 66–77. (In Russ.)

6. Mikerov A.N. Role of the surfactant protein A in the lung immune defense. Fundamental Research. 2012. 2:204—207.

7. Chmura K., Lutz R.D., Chiba H., Numata M.S., Choi H.J., Fantuzzi G., Voelker D.R., Chan E.D. Mycoplasma pneumoniae antigens stimulate interleukin-8. Chest. 2003. 123:425.

8. Shimizu T., Kimura Y., Kida Y. et al. Cytadherence of Mycoplasma pneumoniae Induces Inflammatory Responses through Autophagy and Toll-Like Receptor 4. Infect Immun. 2014. 82(7): 3076—86.

9. Shimizu T. Pathogenic factors of mycoplasma. Nihon Saikingaku Zasshi. 2015. 70 (4):369—374.

10. Naghib M., Hatam-Jahromi M., Niktab M. et. al. Mycoplasma pneumoniae and toll-like receptors: A mutual avenue. Allergol Immunopathol (Madr). 2018. 46(5): 508—513.

11. Kumar S. Mycoplasma pneumoniae: A significant but underrated pathogen in paediatric community-acquired lower respiratory tract infections. Indian J Med Res. 2018 Jan; 147(1):23—31. doi: 10.4103/ijmr.IJMR_1582_16.

12. Naghib M., Hatam-Jahromi M., Niktab M. et. al. Mycoplasma pneumoniae and toll-like receptors: A mutual avenue. Allergol Immunopathol (Madr). 2018. 46 (5): 508—513.

13. Bajantri B., Venkatram S., Diaz-Fuentes G. Mycoplasma pneumoniae: A Potentially Severe Infection. J Clin Med Res. 2018. 10(7):535—544.

14. Nodasaka Y., Hasebe A., Okuzawa T., Nakamura J., Ohata N., Shibata K. Mycoplasmal lipoproteins induce toll-like receptor 2-and caspases mediated cell death in lymphocytes and monocytes. Microbiol Immunol. 2002. 46: 265—276.

15. Segovia J.A., Chang T.H. et.al. Cell Response during Mycoplasma pneumonia Infection. Infect Immun. 2017. 86(1):e00548—17.

16. Nicolson G.L., Marwan, Nasralla Y., Haier J., Erwin R., Nicolson N.L., Ngwenya R. Mycoplasmal Infections in Chronic Illnesses. Med. Sent. 1999; 4(5):172—176.

17. Narita M. Pathogenesis of extrapulmonary manifestations of Mycoplasma pneumonia infection with special reference to pneumonia. J Infect Chemother. 2010;16:162—169.

18. Graw-Panzer K.D., Verma S., Rao S., Miller S. T., and Lee H. Venous thrombosis and pulmonary embolism in a child with pneumonia due to Mycoplasma pneumoniae. J. Natl. Med. Assoc. 2009. 101:956—958. doi: 10.1016/S0027-9684(15)31045-2

19. Trčko K., Marko P. B., and Miljković J. Leukocytoclastic vasculitis induced by Mycoplasma pneumoniae infection. Acta Dermatovenerol. Croat. 2012. 20:118—121.

20. Flateau C., Asfalou I., Deman A.-L., Ficko C., Andriamanantena D., Fontan E., et al. Aortic thrombus and multiple embolisms during a Mycoplasma pneumoniae infection. Infection. 2013. 41:867— 873. doi: 10.1007/s15010-013-0475-2

21. Narita M. Pathogenesis of extrapulmonary manifestations of Mycoplasma pneumonia infection with special reference to pneumonia. J Infect Chemother. 2010;16:162—169.

22. Выставкина Г.В., Харламова Ф.С., Оксамитная Л.Н., Анджель А.Е., Романова Ю.В., Красикова Е.Г. Синдром Стивенса-Джонсона как проявление генерализованной микоплазменной инфекции у детей. Детские инфекции. 2005; 4(2):67—71. Vystavkina G.V., Kharlamova F.S., Oxamitnaya L.N., Angel A.E., Romanova Yu.V., Krasikova E.G. Stevens-Johnson syndrome as a manifestation of generalized mycoplasma infection in children. Detskie Infektsii=Children's Infections. 2005; 4 (2): 67—71. (In Russ.)

23. Харламова Ф.С., О.В. Шамшева, И.В. Полеско, Р.Ю. Юдин, О.С. Остапущенко, Э.Р. Самитова, Д.А. Воробьева, Е.В. Симонова, Н.Л. Вальтц, Н.К. Карасева, А.А. Захарова.Роль сочетанной микоплазменной и герпесвирусной инфекций в формировании патологии сердечно-сосудистой и ЦНС у детей. Педиатрия. 2017; 96(4):48—59. Kharlamova F.S., O.V. Shamsheva, I.V. Polesko, R.Yu. Yudin, O.S. Ostapuschenko, E.R. Samitova, D.A. Vorobeva, E.V. Simonova, N.L. Waltz, N.K. Karaseva, A.A. Zakharova.The role of combined mycoplasma and herpes virus infections in the formation of pathology of the cardiovascular and central nervous system in children. Pediatriya=Pediatrics. 2017; 96 (4): 48—59. (In Russ.)

24. Narita M. Classification of extrapulmonary manifestations due to mycoplasma pneumoniae infection on the basis of possible pathogenesis. Front. Microbiol. 2016. 7(23):1—9.

25. Szymanski M., Petric M., Saunders F.E. et al: Mycoplasma pneumonia pericarditis demonstrated by polymerase chain reaction and electron microscopy. Clin Infect Dis. 2002. 34:E16.

26. Li C.M., Gu L., Yin S.J., Yang R., Xie Y., Guo X.Z., Fu Y.X., Cheng D. Age-specific Mycoplasma pneumoniae pneumonia-associated myocardial damage in children. J Int Med Res. 2013 Oct; 41(5):1716—23. doi: 10.1177/0300060513497559.

27. Fan Q., Meng J., Li P., Liu Z., Sun Y. and Yan P: Pathogenesis and association of Mycoplasma pneumoniae infection with cardiac and hepatic damage. Microbiol Immunol. 2015. 59:375—380.

28. Shin S.R., Park S.H., Kim J.-H., Ha J.-W., Kim Y. J., Jung S.W. et al. Clinical characteristics of patients with Mycoplasma pneumoniaerelated acute hepatitis. Digestion. 2012. 86: 302—308. doi: 10.1159/000341401

29. Yang A., Kang B., Choi S.Y., Cho J.B., Kim Y.-J., Jeon T.Y. et al. Acute necrotizing pancreatitis associated with Mycoplasma pneumoniae infection in a child. Pediatr. Gastroenterol. Hepatol. Nutr. 2015. 18:209—215. doi: 10.5223/pghn.2015.18.3.209

30. Shiihara T., and Takahashi Y. Correspondence: a further case of opsoclonus-myoclonus syndrome associated with Mycoplasma pneumoniae infection. Eur. J. Pediatr. 2010. 169:639.

31. Bae J.-W., Kim H.-J., Chang G.Y., and Kim,E.-J. Combined striatum, brain stem, and optic nerve involvement due to Mycoplasma pneumoniae in an ambulatory child. Case Rep. Neurol. 2011. 3: 109—112. doi: 10.1159/000328836

32. Koga S., Ishiwada N., Honda Y., Okunushi T., Hishiki H., Ouchi K., et al. A case of meningoencephalitis associated with macrolide-resistant Mycoplasma pneumoniae infection. Pediatr. Int. 2012. 54: 724—726. doi: 10.1111/j.1442-200X.2012.03588.

33. Schmucker R.D., Ehret A., and Marshall G.S. Cerebellitis and acute obstructive hydrocephalus associated with Mycoplasma pneumoniae infection. Pediatr. Infect. Dis. J. 2014. 33:529—532. doi: 10.1097/INF.0000000000000140

34. Mellick L.B., Verma N. The Mycoplasma pneumoniae and bullous myringitis myth. Pediatr Emerg Care. 2010 Dec. 26(12):966—8.

35. Greco F., Sorge A., Salvo V., and Sorge G. Cutaneous vasculitis associated with Mycoplasma pneumoniae infection: case report and literature review. Clin. Pediatr. (Phila). 2007. 46:451—453. doi: 10.1177/000992280629863

36. Schalock P.C., and Dinulos J.G.H. Mycoplasma pneumoniae-induced cutaneous disease. Int. J. Dermatol. 2009. 486 673—681. doi: 10.1111/j.1365—4632.2009.04154.x

37. Lee H., Moon K. C., and Kim S. Cutaneous vasculitis and renal involvement in Mycoplasma pneumoniae infection. Korean J. Intern. Med. 2015. 3:402—405. doi: 10.3904/kjim.2015.30.3.402

38. Terraneo L., Lava S.A.G., Camozzi P., Zgraggen L., Simonetti G. D., Bianchetti M.G. et al. Unusual eruptions associated with Mycoplasma pneumoniae respiratory infections: review of the literature. Dermatology. 2015. 231:152—157. doi: 10.1159/000430809

39. Lee M.N., Cha J. H., Ahn H.M., Yoo J.H., Kim H.S., Sohn S., et al. Mycoplasma pneumoniae infection in patients with Kawasaki disease. Korean J. Pediatr. 2011. 54:123—127. doi: 10.3345/kjp.2011.54.3.123

40. Kakuya F., Kinebuchi T., Fujiyasu H., Tanaka R., and Kano H. Mycoplasma pneumoniae infection-induced erythema nodosum, anaphylactoid purpura, and acute urticaria in 3 people in a single family. J. Am. Acad. Dermatol. 2014. 57(2 Suppl.):S33—S35. doi: 10.1016/j.jaad.2005.08.027.

41. Cherry J.D. Anemia and mucocutaneous lesions due to Mycoplasma pneumoniae infections. Clin Infect Dis. 1993, 17:S47—S51. 10.1093/clinics

42. Moon H.J., Yang J.K., In D.H., Kwun D.H., Jo H.H., Chang S.H. A Case of a 14-year-old Girl Who Developed Dermatomyositis Associated with Mycoplasma pneumonia Infection. Soonchunhyang Med Sci. December 2015. 21:130—33.

43. Schwartz R.A., P.H. McDonough, and B.W. Lee. Toxic epidermal necrolysis: part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis. Journal of the American Academy of Dermatology. 2013. 69(2):173.e1—173.e13.

44. Olson D., Watkins L.K.F., Demirjian A., Lin X., Robinson C.C., Pretty K., et al. Outbreak of Mycoplasma pneumoniae-associated StevensJohnson syndrome. Pediatrics. 2015. 136:e386—e394. doi: 10.1542/peds.2015—0278

45. Canavan T.N., Mathes E.F., Frieden I., and Shinkai K. Mycoplasma pneumoniae-induced rash and mucositis as a syndrome distinct from Stevens-Johnson syndrome and erythema multiforme: a systematic review. J. Am. Acad. Dermatol. 2015. 72:239—245. doi: 10.1016/j.jaad.2014.06.026

46. Alerhand S., C. Cassella, and A. Koyfman. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the Pediatric Population: A Review. Pediatric Emergency Care, 2016. 32(7): 472—478.

47. Cho Y.T., Chu C.Y. Treatments for Severe Cutaneous Adverse Reactions. J.Immunol.Res. 2017. 1503709. DOI:10.1155/2017/1503709.

48. Espinoza-Camacho D., Monge-Ortega O.P., Sedo-Mejia G. Mycoplasma pneumoniae-induced atypical Steven-Johnson syndrome: a diagnostic challenge. Rev Alerg Mex. 2018. 65(4):437—441.

49. Халдина М.В., О.Л. Иванов, А.А. Халдин, В.В. Малиновская, Е.Н.Мешкова. Опыт применения виферона в профилактике герпесассоциированной многоформной экссудативной эритемы. Российский журнал кожных и венерических болезней. 2005; 5:51—53. Khaldina M.V., O.L. Ivanov, A.A. Haldin, V.V. Malinovskaya, E.N. Meshkova. Experience in the use of viferon in the prevention of herpes-associated multiforme exudative erythema. Rossiyskiy Zhurnal Kozhnykh i Venericheskikh Bolezney=Russian Journal of Skin and Sexually Transmitted Diseases. 2005; 5: 51—53. (In Russ.)

50. Кузьмук-Хрусталева Д.Ю., Короткий Н.Г., Кубылинский А.А., Уджуху В.Ю., Стовбун С.В., Кучеров В.А. Эффективность нового вида иммуномодулирующей терапии больных многоформной экссудативной эритемой. Вестник Российского государственного медицинского университета. Дерматология. 2011; 2:50—58. Kuzmuk-Khrustaleva D.Yu., Korotky N.G., Kubylinsky A.A., Ujuhu V.Yu., Stovbun S.V., Kucherov V.A. The effectiveness of a new type of immunomodulating therapy in patients with erythema multiforme exudative. Bulletin of the Russian State Medical University. Dermatology. 2011; 2: 50-58. (In Russ.)

51. Susheera Chatproedprai, Vanvara Wutticharoenwong, Therdpong Tempark, and Siriwan Wananukul. Clinical Features and Treatment Outcomes among Children with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 20-Year Study in a Tertiary Referral Hospital. Dermatology Research and Practice. Volume 2018 May 7, Article ID 3061084, 9 https://doi.org/10.1155/2018/3061084

52. Sneddon I.B., Wilkinson D.S. Subcorneal pustular dermatosis. Br J Dermatol. 1956. 68:385.

53. Sneddon I.B., Wilkinson D.S. Subcorneal pustular dermatosis. Br J Dermatol. 1979;100(1):61—8.

54. Winnock T., Wang J., Suys E., De Coninck A., Roseeuw D. Vesiculopustular eruption associated with Mycoplasma pneumoniae pneumopathy. Dermatology. 1996;192(1):73—4.

55. Papini M., Cicoletti M., Landucci P. Subcorneal pustular dermatosis and Mycoplasma pneumoniae respiratory infection. Acta Derm Venereol. 2003; 83(5):387—8.

56. Lombart F., Dhaille F., Lok C., Dadban A. Subcorneal pustular dermatosis associated with Mycoplasma pneumoniae infection. J Am Acad Dermatol. 2014; 71(3):85—6. 52.

57. Bohelay G., Duong T.A., Ortonne N., Chosidow O., ValeyrieAllanore L. Subcorneal pustular dermatosis triggered by Mycoplasma pneumoniae infection: a rare clinical association. J Eur Acad Dermatol Venereol. 2015; 29(5):1022—55.

58. Cheng S., Edmonds E., Ben-Gashir M., Yu R.C. Subcorneal pustular dermatosis: 50 years on. Clin Exp Dermatol. 2008; 33(3):229—33.

59. Abreu Velez A.M., Smith J.G.Jr, Howard M.S. Subcorneal pustular dermatosis an immnohisto-pathological perspective. Int J Clin Exp Pathol. 2011; 4(5):526—9.

60. Scalvenzi M., Palmisano F., Annunziata M.C., Mezza E., Cozzolino I., Costa C. Subcorneal pustular dermatosis in childhood: a case report and review of the literature. Case Rep Dermatol Med. 2013. doi: 10.1155/2013/424797.

61. Prat L., Bouaziz J.D., Wallach D., Vignon-Pennamen M.D., Bagot M. Neutrophilic dermatoses as systemic diseases. Clin Dermatol. 2014; 32(3):376—88.

62. Maalouf D., Battistella M., Bouaziz J.D. Neutrophilic dermatosis: disease mechanism and treatment. Curr Opin Hematol. 2015; 22(1):23—9.

63. Paula Jean Watts, Amor, Khachemoune. Subcorneal Pustular Dermatosis: A Review of 30 Years of Progress. American Journal of Clinical Dermatology; December 2016. 17(6):653—671.


Review

For citations:


Kuvardina H.O., Kharlamova F.S., Polesko I.V., Shamsheva O.V., Ostapuschenko O.S. The role of mixed Mycoplasma and Herpesvirus infections in case of skin lesions in children. CHILDREN INFECTIONS. 2019;18(3):5-10. (In Russ.) https://doi.org/10.22627/2072-8107-2019-18-3-5-10

Views: 1374


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2072-8107 (Print)
ISSN 2618-8139 (Online)