Table. Patient Disease Courses and Responses.

Patient No./age group	Prodromal symptoms	Mucocutaneous involvementa	Infectious workupb	Length of hospital stay (days to discharge after etanercept dose), d	Other interventionsc	Improvement on physical examination after etanercept treatment, d	Advancement of diet after etanercept treatment, d	Discontinuation of as-needed pain medications after etanercept treatment, dd	Follow-up
1/Child	5-d History of fever, productive cough, progressive rash, and mucositis	Oral and ocular; 5% BSA affecting trunk and extremities	CXR with perihilar infiltrates; positive for Mycoplasma pneumoniae by PCR; negative for RVPA by PCR; negative for HSV; negative for HSV 1 and 2 IgG and IgM by PCR	12 (12)	Azithromycin ×5 d; amniotic ocular membrane; nasogastric tube placement	3	5	5	No ophthalmological consequences; no permanent cutaneous consequences
2/Adolescent	6-d History of fever; productive cough; and generalized weakness, progressive rash, and mucositis	Oral, ocular and genital; 25% BSA affecting face, trunk, and extremities	No CXR; positive for M pneumoniae IgM and IgG; positive for rhinovirus; negative for HSV 1 and 2 and VZV by PCR	4 (4)	Azithromycin ×5 d; topical mupirocin 2% ointment; lidocaine-diphenhydramine hydrochloride-Maalox mouthwash; dexamethasone-neomycin sulfate-polymyxin B sulfate eye drops	1	No change	Did not require any as-needed pain medications during hospital stay	No ophthalmological consequences; no permanent cutaneous consequences
3/Adolescent	5-d History of fever, dysphagia, productive cough, and mucositis	Oral and ocular; <1% BSA	CXR with bibasilar, bilateral infiltrates, positive for M pneumoniae by PCR; negative RVP result; negative for HSV 1 and 2 by PCR	3 (3)	1 Oral dose of dexamethasone at outside hospital ED; clindamycin hydrochloride ×2 d; azithromycin ×5 d	2	No change	2	No follow-up
4/Child	2-wk History of cough and generalized malaise with 3 d of progressive rash	Oral, ocular, and genital; 60% BSA affecting face, back, trunk, palms, soles, and extremities	CXR with perihilar opacities; negative for M pneumoniae by PCR; positive for M pneumoniae IgM and IgG; negative RVP result	5 (5)	Azithromycin ×5 d; erythromycin ocular ointment; prednisolone sodium phosphate eye drops	2	1	2	No follow-up
5/Child	9-d History of fevers and joint pains and mucositis	Oral; <1% BSA	No CXR; negative for M pneumoniae by PCR; positive for M pneumoniae IgM, negative for M pneumoniae IgG; negative RVP result; negative for HSV 1 and 2 by PCR, negative for HSV 1 and 2 IgG and IgM	9 (9)	Acyclovir ×2 d; azithromycin ×5 d; clindamycin ×5 d; nasogastric tube placement	2	2	4	No ophthalmological consequences; no permanent cutaneous consequences
6/Child	2-d History of fevers, malaise, dysphagia, and progressive rash	Oral, ocular and anogenital; 10% BSA affecting abdomen, forearms, dorsal surface of hands, and proximal thighs	No CXR; negative for M pneumoniae by PCR; negative for M pneumoniae IgM and IgG and influenza A and B; positive for Coxsacksie B3 IgG; negative RVP result	4 (4)	No antibiotics, lidocaine-diphenhydramine-Maalox mouthwash; artificial tears	1	1	1	No ophthalmological consequences; no permanent cutaneous consequences

Abbreviations: BSA, body surface area; CXR, chest x-ray; ED, emergency department; HSV, herpes simplex virus; IgG/IgM, immunoglobulin G or M; PCR, polymerase chain reaction; RVPA, right ventricle pulmonary artery; RVP, respiratory virus panel; VZV, varicella zoster virus.

^aBSA was identified retrospectively by photographs.

^bRespiratory virus panel nasal PCR at our institution included adenovirus, coronavirus, metapneumovirus, rhinovirus, enterovirus, influenza A and B, parainfluenza, and respiratory syncytial virus.

^cOral or by mouth intake was based on volume of liquid consumed in a day or the advancement of diet from liquids to soft solids to solid.

^dAs-needed pain medications included oral acetaminophen, toradol, and morphine sulfate.