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Peer-reviewedCC BYFrontiers in Pediatrics

Care and outcome of a child with erythema multiforme complicated by secondary bacterial infection: a case report

  • Nannan Li1
  • Zhe Zhang2
  • Yujie Lu2
  • Huanling Wu1
  • Yu Zhang1
  • Zhong Li2
  • Fenghui Cong3
  1. 1Hematology-Oncology Department, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China
  2. 2Department of Pharmacy, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China
  3. 3Department of Nursing, Dalian Women and Children’s Medical Group, Dalian, Liaoning, China
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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.

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Cite

BibTeXRIS
BibTeX
@article{li2026care,
  title = {{Care and outcome of a child with erythema multiforme complicated by secondary bacterial infection: a case report}},
  author = {Nannan Li and Zhe Zhang and Yujie Lu and Huanling Wu and Yu Zhang and Zhong Li and Fenghui Cong},
  journal = {Frontiers in Pediatrics},
  year = {2026},
  month = oct,
  doi = {10.3389/fped.2026.1916599},
  url = {https://doi.org/10.3389/fped.2026.1916599},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Care and outcome of a child with erythema multiforme complicated by secondary bacterial infection: a case report
AU  - Nannan Li
AU  - Zhe Zhang
AU  - Yujie Lu
AU  - Huanling Wu
AU  - Yu Zhang
AU  - Zhong Li
AU  - Fenghui Cong
PY  - 2026
DA  - 2026/10/26
JO  - Frontiers in Pediatrics
DO  - 10.3389/fped.2026.1916599
UR  - https://doi.org/10.3389/fped.2026.1916599
AB  - 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.
SN  - 2296-2360
ER  -