Ocular manifestations of reactive infectious mucocutaneous eruption (RIME) secondary to adenovirus: A case report

L H Young; S B Kim; J S Takhar; L D Sun; K M White; A F Omar

doi:10.1016/j.ajoc.2025.102363

Ocular manifestations of reactive infectious mucocutaneous eruption (RIME) secondary to adenovirus: A case report

Am J Ophthalmol Case Rep. 2025 Jun 7:39:102363. doi: 10.1016/j.ajoc.2025.102363. eCollection 2025 Sep.

Authors

L H Young^{1

2}, S B Kim¹, J S Takhar^{1

2}, L D Sun^{1

3}, K M White^{1

2}, A F Omar^{1

2

4}

Affiliations

¹ Case Western Reserve University School of Medicine. Cleveland, OH, USA.
² University Hospitals Cleveland Medical Center, Department of Ophthalmology. Cleveland, OH, USA.
³ University Hospitals Cleveland Medical Center, Department of Dermatology. Cleveland, OH, USA.
⁴ Department of Ophthalmology, Assiut University Hospitals, Assiut, Egypt.

Abstract

Purpose: To present an atypical case of reactive infectious mucocutaneous eruption (RIME) in an adult patient attributed to primary adenoviral infection.

Observations: This is a case describing the clinical course of a previously healthy 34-year old man who presented with acute onset urethritis and bilateral conjunctivitis. His left eye conjunctivitis progressed to pseudomembrane and symblepharon formation within days. His clinical course was marked by progressive worsening of urethritis and formation of mucus membrane ulceration and bullae even after antibiotic treatment and aggressive topical lubrication. He required admission and a multidisciplinary team made the diagnosis of adenovirus-induced RIME. He was treated with intravenous steroids and intravenous cyclosporine. He ultimately recovered with a good visual outcome.

Conclusions and importance: This case demonstrates a rare case of RIME in an adult triggered by an adenovirus infection. Multidisciplinary care is key to diagnosis and treatment.

Keywords: Adenovirus; Conjunctivitis; Reactive infectious mucocutaneous eruption (RIME).

Publication types

Case Reports