Abstract
Mycoplasma pneumoniae (M. pneumoniae) typically presents with respiratory symptoms and is considered a common cause of community-acquired pneumonia. M. pneumoniae infection occasionally presents with extrapulmonary manifestations, among which reactive infectious mucocutaneous eruption (RIME) represents an infrequent but clinically significant complication. This dermatological sequela, while uncommon, underscores the systemic potential of M. pneumoniae infections beyond their typical respiratory presentation. Herein, a 24-year-old man presented to the hospital with a recent diagnosis of mycoplasma pneumonia and symptoms that included severe mucositis, conjunctivitis, dysuria, and targetoid skin lesions. The initial, broad therapy with antibiotics, including doxycycline and azithromycin, was quickly followed by exacerbation of his symptoms, requiring systemic corticosteroid therapy. There was a significant clinical improvement with the intravenous use of methylprednisolone within three days. This case represents an extremely rare age group, echoing that early recognition and management of RIME are of utmost importance.