Chronic Spontaneous and Inducible Urticaria Associated With Mycoplasma pneumoniae Infection

Abstract

Acute childhood urticaria is a common disorder that has been associated with infections. In a few children, it may last for more than six weeks, thereafter it is characterized as chronic urticaria (CU). We report two cases, one suffering from chronic spontaneous urticaria and one chronic inducible urticarias (dermographism and cold urticaria). Both children had concomitant respiratory symptoms that were associated with Mycoplasma pneumoniae (MP) infection. Urticarias' symptoms and signs were refractory to regular antihistamines dose but showed marked improvement or complete resolution following clarithromycin administration. CU response to antibiotics pointed strongly to a potential causative role of MP in the pathogenesis of chronic spontaneous and chronic inducible urticarias. It is not clear if MP was the etiopathogenic cause or just the trigger. Nevertheless, refractory to antihistamines urticarias associated with MP infection may respond to antibiotics, which should be considered as an alternative therapeutic approach.

New-onset chronic spontaneous urticaria development after COVID-19 vaccination

“…We know that CSU could co-occur together with CIndU; however, they are different entities. 2 Therefore, the title “New-Onset Chronic Urticaria” would have been more appropriate. Moreover, those patients in the study who had CIndU were said to have cholinergic urticaria, but information about how this diagnosis was made was not given anywhere in the entire article.…”

Cold Urticaria due to Amoxicillin–Clavulanic Acid

“…After all, it is well known that chronic spontaneous/idiopathic urticaria can recur with some drugs or be triggered by different physical inducers [4,5]. In the case described, the fact that the ice cube test performed 2 hours after the drug tolerance test became positive despite the negativity of the ice cube test while there were clinical findings in the beginning, raises suspicion about whether this is a typical cold-induced urticaria reaction in an atopic patient who we think may have chronic spontaneous urticaria.…”

Cough and urticarial rash in an 11-year-old child

“…In patients with persistent urticaria, M. pneumoniae infection should be considered to make a correct diagnosis and administer adequate treatment 3 .…”