Atypical bacterial pathogens and small-vessel leukocytoclastic vasculitis of the skin in children

Betti, Céline; Camozzi, Pietro; Gennaro, Viola; Bianchetti, Mario G.; Scoglio, Martin; Simonetti, Giacomo D.; Milani, Gregorio P.; Lava, Sebastiano A. G.; Ferrarini, Alessandra

doi:10.3390/pathogens10010031

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Journal article

Atypical bacterial pathogens and small-vessel leukocytoclastic vasculitis of the skin in children : systematic literature review

Betti, Céline Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Department of Pediatrics, Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
Camozzi, Pietro Department of Internal Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
Gennaro, Viola Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Bianchetti, Mario G. Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Scoglio, Martin Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Simonetti, Giacomo D. Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Department of Pediatrics, Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
Milani, Gregorio P. Department of Pediatrics, Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland - Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy - Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Italy
Lava, Sebastiano A. G. Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
Ferrarini, Alessandra Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Department of Pediatrics, Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland

02.01.2021

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Pathogens. - 2021, vol. 10, no. 1, p. 9 p

Leukocytoclastic small-vessel vasculitis

English Leukocytoclastic small-vessel vasculitis of the skin (with or without systemic involvement) is often preceded by infections such as common cold, tonsillopharyngitis, or otitis media. Our purpose was to document pediatric (≤18 years) cases preceded by a symptomatic disease caused by an atypical bacterial pathogen. We performed a literature search following the Preferred Reporting of Systematic Reviews and Meta-Analyses guidelines. We retained 19 reports including 22 cases (13 females and 9 males, 1.0 to 17, median 6.3 years of age) associated with a Mycoplasma pneumoniae infection. We did not find any case linked to Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella pneumophila. Patients with a systemic vasculitis (N = 14) and with a skin-limited (N = 8) vasculitis did not significantly differ with respect to gender and age. The time to recovery was ≤12 weeks in all patients with this information. In conclusion, a cutaneous small-vessel vasculitis with or without systemic involvement may occur in childhood after an infection caused by the atypical bacterial pathogen Mycoplasma pneumoniae. The clinical picture and the course of cases preceded by recognized triggers and by this atypical pathogen are indistinguishable.

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