key: cord-0964415-ill954nt
authors: Monte Serrano, Juan; García‐Gil, Miguel Fernando; Cruañes Monferrer, Joana; Aldea Manrique, Beatriz; Prieto‐Torres, Lucía; García García, Mar; Matovelle Ochoa, Cristina; Ara‐Martín, Mariano
title: COVID‐19 and Mycoplasma pneumoniae: SARS‐CoV‐2 false positive or coinfection?
date: 2020-08-07
journal: Int J Dermatol
DOI: 10.1111/ijd.15090
sha: 31983d314bff0d109189ddc4aebcde7244c25f15
doc_id: 964415
cord_uid: ill954nt

nan

Several skin lesions have been associated with COVID-19, some of them classically related to other microbiological agents, making a thorough differential diagnosis essential. The detection of nucleic acid from SARS-CoV-2 is the direct evidence for a COVID-19 diagnosis, but nasopharyngeal swabs may not always reveal the SARS-CoV-2 infection. Using enzyme-linked immunosorbent assay (ELISA) to detect SARS-CoV-2 IgM can identify or screen SARS-CoV-2 infection in suspicious and close-contact populations. False-positive results from a serological test for SARS-CoV-2 have recently been described in patients with middle-high level of rheumatoid factor-IgM. 1 We report two patients who showed skin lesions associated with COVID-19 and false-positive compatible results using ELISA to detect SARS-CoV-2 IgM, who were later confirmed to have acute Mycoplasma pneumoniae infection.

The first case is a 48-year-old man with no significant past medical history who came to the emergency department presenting with a 5-day history of widespread urticarial, nonevanescent eruption and fever (Fig. 1) . He also had a nonproductive cough and headache. No new drugs were given. A chest radiography was performed, and no radiological signs consistent with pneumonia were found. Treatment with H1-anti- Many cutaneous findings of COVID-19 are nonspecific.

Mycoplasma pneumoniae infection, such as Fuchs' syndrome, vasculitis (Henoch-Sch€ onlein syndrome, urticarial vasculitis), erythema nodosum, and varicella-like eruptions. 2 The skin lesions we present have been described in patients with 

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