{
  "abstract": "Erythema multiforme (EM) is an acute mucocutaneous disorder usually triggered by infections. Chemical injury with secondary bacterial infection is a rare trigger in children. We report an 11-year-old boy who initially had a punctate oral ulcer, in whom overnight buccal metronidazole likely caused additional chemical irritation, followed by secondary Staphylococcus aureus infection and a subsequent diagnosis of EM. Laboratory findings revealed a marked decrease in CD4+ T cells (185/μL) and a reduced CD4/CD8 ratio (0.66). Lesions progressed from the oral cavity to the extremities, with severe lip and oral involvement. Initial burn-based wound care was ineffective. Following diagnosis, a structured wound care protocol was implemented, consisting of sequential topical ethacridine lactate, mupirocin, compound triamcinolone acetonide, and recombinant human epidermal growth factor, with continuous low-flow oxygen. The lesions improved markedly, lip ulcers healed, oral function returned, and the patient was discharged well. This case underscores the need for early EM recognition in children with atypical oral lesions and describes a structured, multistep nursing strategy that was used in this case.",
  "abstract_shown": true,
  "affiliations": [
    "Hematology-Oncology Department, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China",
    "Department of Pharmacy, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China",
    "Department of Nursing, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nannan Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhe Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Yujie Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Huanling Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhong Li"
    },
    {
      "affs": [
        2
      ],
      "name": "Fenghui Cong"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ckgsad0p2vp9e.bib",
  "cited_by": 0,
  "doi": "10.3389/fped.2026.1916599",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fped.2026.1916599/full",
  "id": "ckgsad0p2vp9e",
  "issns": [
    "2296-2360"
  ],
  "landing_url": "https://doi.org/10.3389/fped.2026.1916599",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RJ1-570"
    ],
    [
      "openalex",
      "2736|Drug-Induced Adverse Reactions"
    ]
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  "openalex": "W7223701902",
  "pdf_url": "https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1916599/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/ckgsad0p2vp9e.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:47:27Z",
      "native_id": "2a0eb05da9ba42a58523563fc7b0dc5b",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fped.2026.1916599"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2736|Drug-Induced Adverse Reactions",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Care and outcome of a child with erythema multiforme complicated by secondary bacterial infection: a case report",
  "title_text": "Care and outcome of a child with erythema multiforme complicated by secondary bacterial infection: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:47:27Z",
  "url": "https://research.draconitic.com/paper/ckgsad0p2vp9e",
  "venue": "Frontiers in Pediatrics",
  "versions": []
}