Nikhil Prasad Fact checked by:Thailand Medical News Team Oct 04, 2025 1 hour, 54 minutes ago
Medical News: Rare Case of RIME in a Child After COVID-19 and Mycoplasma Co-Infection
Doctors in Romania have reported a striking case of a young boy who developed a rare and severe condition known as Reactive Infectious Mucocutaneous Eruption or RIME after being infected with both SARS-CoV-2 and Mycoplasma pneumoniae. The case was documented by researchers from the George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș and the Emergency County Clinical Hospital of Târgu Mureș. This
Medical News report shows how dual infections may combine to create a stronger immune reaction that puts children at risk of more complex illnesses.
What is RIME and Why It Matters
RIME is a rare but serious condition that mainly affects children after respiratory infections. It causes painful ulcers in the mouth, inflammation of the eyes, and sometimes rashes on the skin. Doctors often confuse it with Stevens–Johnson Syndrome, a drug-related reaction, but unlike that disorder, RIME is caused by infections. In this case, both COVID-19 and Mycoplasma pneumoniae acted as triggers, which may explain the unusually severe symptoms.
Details of the Case
The patient was a 12-year-old boy who arrived at the hospital with nine days of fever, cough, vomiting, and difficulty swallowing. He had severe oral ulcers, red swollen eyes, and a spreading rash. Tests showed he was infected with both Mycoplasma pneumoniae and SARS-CoV-2. Surprisingly, doctors also found he had sinus bradycardia, a condition where the heart beats abnormally slow, even though his heart structure was normal. The boy was treated with antibiotics, strong intravenous steroids, antifungal medicine, and supportive care including oxygen. His symptoms improved quickly, and he was discharged in stable condition after just seven days. Follow-up after twelve days showed nearly complete recovery.
Why This Case is Important
Doctors emphasized three major lessons from this unusual case. First, children with both viral and bacterial infections may develop stronger immune reactions that trigger rare illnesses like RIME. Second, the temporary heart rhythm changes observed show that infections can sometimes affect the heart without leaving permanent damage. Third, the successful use of corticosteroids, a treatment sometimes debated, shows that they can be effective in severe cases when used carefully under medical supervision.
Wider Implications
Since the COVID-19 pandemic, cases of Mycoplasma pneumoniae infections in children have risen sharply across Europe. Doctors are now seeing more cases of RIME linked to both Mycoplasma and SARS-CoV-2. This highlights the need for greater awareness among parents and doctors, as early recognition can prevent misdiagnosis and ensure children receive the right treatment quickly. The findings also point to the importance of monitoring heart health in children with severe infections, even when symptoms may not initially seem heart-related.
Conclusion
This case sheds light on how infections can interact to tri
gger severe immune reactions in children. It also underlines the importance of recognizing RIME as a distinct illness and treating it promptly with the right combination of antibiotics and steroids. While rare, such cases remind doctors and families alike to remain alert when children show unusual symptoms after respiratory infections. More research is needed to better understand why some children develop RIME and how to prevent it.
The study findings were published in the peer reviewed journal: Infectious Diseases Reports.
https://www.mdpi.com/2036-7449/17/5/121
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https://www.thailandmedical.news/news/prolonged-covid-19-induced-cardiac-threat-in-children-giant-coronary-aneurysms-linked-to-mis-c-can-persist-for-years
https://www.thailandmedical.news/news/hospitalized-children-with-covid-19-found-to-have-disrupted-gut-microbiomes-and-missing-key-vitamins
https://www.thailandmedical.news/news/sharp-rise-in-dangerous-ear-and-sinus-infections-in-children-after-covid-19
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