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

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

Research output: Contribution to journalReview articlepeer-review


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.

Original languageEnglish
Article number31
Number of pages9
Issue number1
Publication statusPublished - Jan 2021


  • Atypical pathogens
  • Chlamydophila pneumoniae
  • Chlamydophila psittaci
  • Coxiella burnetii
  • Francisella tularensis
  • Legionella pneumophila
  • Leukocytoclastic small-vessel vasculitis
  • Mycoplasma pneumoniae

ASJC Scopus subject areas

  • Immunology and Allergy
  • Molecular Biology
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases


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