Background: Toxic Epidermal Necrolysis (TEN) is a rare, life-endangering emergency condition with a high mortality rate. While medications are recognized as common trigger factors, infections like Mycoplasma pneumoniae are also increasingly being recognized as other potential triggers, particularly in the pediatric population.
Case: A 6-year-old boy presented with fever, sore throat and an erythematous rash that rapidly progressed to form multiple vesicles and flaccid bullae, affecting 70% of total body surface area. Additionally, peeling of sheets of skin was noted, accounting for 30% of body surface area. A diagnosis of Toxic Epidermal Necrolysis was formed. Laboratory tests revealed increased levels of IgA to Mycoplasma pneumoniae and together with the results of chest x-ray, allowed for a diagnosis of right-sided pneumonia. For management of TEN, IVIG, followed by Methylprednisolone pulses was provided. This was combined with antibacterial therapy and supportive care. The patient made a complete recovery with no complications after 36 days under Intensive Care.
Conclusion: This case underscores Mycoplasma pneumoniae as a pediatric TEN trigger. It also serves to highlight the efficacy of combined immunotherapy and multidisciplinary care and the importance of early intervention in minimizing complications, especially in such severe cases.