Atypical Bacterial Pathogens and Small-Vessel Leukocytoclastic Vasculitis of the Skin in Children: Systematic Literature Review

Betti, Céline; Camozzi, Pietro; Gennaro, Viola; Bianchetti, Mario G.; Scoglio, Martin; Simonetti, Giacomo D.; Milani, Gregorio P.; Lava, Sebastiano A. G.; Ferrarini, Alessandra

doi:10.3390/pathogens10010031

Cited by 11 publications

(9 citation statements)

References 38 publications

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“…Epidemics of M. pneumoniae pneumonia have occurred in 3-4-year cycles in South Korea, with the most recent epidemic occurring in 2019 [2,3]. Although most patients with M. pneumoniae pneumonia have mild symptoms and a self-limited clinical course, some patients experience severe or refractory pneumonia and/or extrapulmonary complications, such as encephalopathy, Stevens-Jonson syndrome, small-vessel cutaneous vasculitis, myositis, and acute kidney injury, as well as other organ involvement [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

Han

Park

Yang

et al. 2021

JCM

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We have found that early corticosteroid therapy was effective for reducing morbidity during five Korea-wide epidemics. We evaluated the clinical and laboratory parameters of 56 children who received early corticosteroid treatment for pneumonia that was caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae) or macrolide-sensitive M. pneumoniae between July 2019 and February 2020. All subjects had dual positive results from a PCR assay and serological test, and received corticosteroids within 24–36 h after admission. Point mutation of residues 2063, 2064, and 2067 was identified in domain V of 23S rRNA. The mean age was 6.8 years and the male:female ratio was 1.2:1 (31:25 patients). Most of the subjects had macrolide-resistant M. pneumoniae (73%), and all mutated strains had the A2063G transition. No significant differences in clinical and laboratory parameters were observed between macrolide-resistant and macrolide-sensitive M. pneumoniae groups that were treated with early dose-adjusted corticosteroids. Higher-dose steroid treatment may be needed for patients who have fever that persists for >48 h or increased biomarkers such as lactate dehydrogenase concentration at follow-up despite a usual dose of steroid therapy.

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Section: Introductionmentioning

confidence: 99%

Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

Han

Park

Yang

et al. 2021

JCM

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“…This sign characteristically occurs in streptococcal and staphylococcal scarlet fever and, less frequently, in eruptions caused by Mycoplasma pneumoniae [ 5 , 6 ]. There is no common association between Mycoplasma pneumoniae or Streptococcus A and AHE because this microorganism usually causes infections in children 4 years or more of age [ 5 , 91 , 92 ]. Remarkably, AHE was associated with Mycoplasma pneumoniae or Streptococcus A in three of the cases with a Pastia sign.…”

Section: Discussionmentioning

confidence: 99%

Köbner and Pastia Signs in Acute Hemorrhagic Edema of Young Children: Systematic Literature Review

et al. 2022

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Acute hemorrhagic edema of young children, a benign skin-limited vasculitis, predominantly affects children 2 years of age or younger. The prevalence and clinical features of the Köbner and Pastia signs have never been systematically investigated in this vasculitis. To address this issue, we analyzed the data contained in the Acute Hemorrhagic Edema Bibliographic Database, which incorporates all reports on hemorrhagic edema published after 1969. A total of 339 cases (236 males and 103 females; 11 (8–18) months of age; median and interquartile range) were documented with at least 1 photograph and therefore included in this analysis. The Köbner sign occurred in 24 cases (14 males and 10 females; 11 (7–17) months of age), the Pastia sign in 51 cases (39 males and 12 females; 11 (8–15) months of age), and both Köbner and Pastia signs in 8 cases (7 males and 1 female; 11 (7–17) months of age). The lower legs, thighs, waistline, and groin were the regions that were most commonly affected with the Köbner sign, while the ankle, feet, cubital fossa, and elbow were most affected with the Pastia sign. The Köbner and Pastia signs are clinically relevant; they occur in about every fourth child affected with hemorrhagic edema and do not influence the disease progression.

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“…Both Finkelstein-Seidlmayer vasculitis and immunoglobulin A vasculitis are often preceded either by a vaccination or, more frequently, an infection. However, Streptococcus pyogenes and atypical bacterial pathogens including Mycoplasma very often precede immunoglobulin A vasculitis but rather rarely precede Finkelstein-Seidlmayer vasculitis [ 20 , 22 , 23 ]. This difference is likely related to the fact that Streptococcus pyogenes [ 24 ] and atypical bacterial pathogens [ 25 ] rarely affect subjects 4–5 years or less of age.…”

Section: Discussionmentioning

confidence: 99%

Infections or Vaccines Associated with Finkelstein-Seidlmayer Vasculitis: Systematic Review

Bronz

Betti

Rinoldi

et al. 2022

Clinic Rev Allerg Immunol

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Finkelstein-Seidlmayer vasculitis, also referred to as acute hemorrhagic edema of young children, is a rare small-vessel leukocytoclastic vasculitis. This condition is skin-limited, mainly affects infants up to 2 years of age and spontaneously remits. It has been suggested that an infection or a vaccine precede (by ≤ 14 days) this vasculitis. To better understand the interplay between infections or vaccines and Finkelstein-Seidlmayer vasculitis, we utilized the data contained in the Acute Hemorrhagic Edema BIbliographic Database AHEBID. The database, initiated in 2019, is being regularly updated, encompasses the entire original literature on Finkelstein-Seidlmayer vasculitis published after the original description and is attainable on request. The possible existence of an infectious or a vaccine precursor was addressed in 447 cases. Most cases were preceded by an infection (N = 384; 86%), by a vaccination (N = 20; 4.4%), or both an infection and a vaccination (N = 17; 3.8%). No precursor was reported in the remaining cases (N = 26; 5.8%). Two distinct infections preceded the onset of the vasculitis in 11 of the 381 cases with infection-associated Finkelstein-Seidlmayer vasculitis. The following infectious precursors were reported: upper respiratory tract infection (N = 292); acute gastroenteritis (N = 40); a benign febrile infection (N = 36); lower respiratory tract infection (N = 22); further infections (N = 8). The temporal relationship between the infectious precursor and the onset of the skin eruption was detailed in 336 cases: 54 cases developed before resolution and 282 after resolution of the infection. In conclusion, most cases of Finkelstein-Seidlmayer vasculitis are preceded by an infection. In a minority of cases, this skin vasculitis develops before resolution of the infection. In most cases, however, this vasculitis develops after resolution of the infection. More rarely, this vasculitis is preceded by a vaccination.

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Atypical Bacterial Pathogens and Small-Vessel Leukocytoclastic Vasculitis of the Skin in Children: Systematic Literature Review

Cited by 11 publications

References 38 publications

Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

Köbner and Pastia Signs in Acute Hemorrhagic Edema of Young Children: Systematic Literature Review

Infections or Vaccines Associated with Finkelstein-Seidlmayer Vasculitis: Systematic Review

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