What is your diagnosis?
A 26-year-old previously healthy man presented to the emergency department with a 3-day history of fever, dry cough, and nonpruritic rash. A physical examination was notable for crackles on the left side of the chest and a macular, targetoid rash on his hands and feet, including the palms and soles. Over the next 3 days, severe mucositis developed that involved the lips, buccal mucosa, conjunctivae, and urethral meatus. What is the diagnosis? a) Herpes simplex virus-1 gingivostomatitis b) Stevens–Johnson syndrome c) Behçet’s disease d) Mucocutaneous Epstein–Barr virus e) Mycoplasma pneumoniae-associated mucositis source: nejm.org
Its not Stevens Johnson. SJS has a previous history of Drug use and affects the Skin too. Here, only the mucois membranes and Conjunctiva are affected. Besides, The fever, Cough and non pruritic Target macule go in favour of Mycoplasma Pneumonia. Mucositis is an extrapulmonary complication of Pneumonia. Mucositis in M.pneumonia is a part of the Spectrum of so called SJS but the Pulmonary manifestations and rash suggest Mycoplasma.
I don't think it's Stevens-Johnson Syndrome, because that rash is usually purple-ish, right?
B. The target lesions and soles and palms affected are pathopnomonic
