Toxic epidermal necrolysis secondary to Mycoplasma pneumoniae and herpes simplex virus infection

Summary Toxic epidermal necrolysis (TEN) is a life-threatening skin reaction associated with a high mortality rate. Most TEN is induced by drugs, but some cases are caused by other insults. Mycoplasma pneumoniae and herpes simplex virus are the most common infectious pathogens associated with TEN. In identifying the etiology of TEN, it is crucial to include not only a detailed drug history but also potential infection sources. Any suspicious infections should be treated in a timely and efficient manner to improve survival rates. In this article, we report on five patients who developed TEN related to M. pneumoniae and herpes simplex virus infections. We also reviewed the relevant literature. We performed a retrospective medical chart review of five patients with TEN, which was considered secondary to M. pneumoniae and herpes simplex virus infections. We compared patients with infection-induced and drug-induced TEN. We found that patients with infection-induced TEN were younger in age and had lower SCORTEN scores, less renal dysfunction, shorter hospitalization periods, and higher survival rates compared with patients with drug-induced TEN. Identifying the etiology of TEN requires the inclusion of not only a detailed drug history but also infection sources, such as M. pneumoniae and herpes simplex virus. Our findings corroborate previously reported clinical and etiologic association with TEN. TEN induced by M. pneumoniae and herpes simplex virus manifested less severe clinical courses than its drug-induced counterpart.