Imaging clinical case

  • Cristiana Martins Pediatrics Department, Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro
  • Jorge Ferreira Pediatrics Department, Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro
  • Gabriela Pereira Pediatrics Department, Unidade Hospitalar de Chaves, Centro Hospitalar de Trás-os-Montes e Alto Douro
Keywords: Hemorrhagic edema, Purpuric rash

Abstract

Introduction: Acute hemorrhagic edema of infancy (AHEI) is a rare and benign leukocytoclastic vasculitis, frequently misdiagnosed.
Case report: A twelve-month-old boy presented with a seven-day history of coryza and cough associated with lowgrade fever and the sudden appearance of a purpuric rash over the left lower limb. It progressed to an annular purpuric rash, with well-defined edges, on the face, limbs, ears, buttocks, and scrotum, with right tibiotarsal joint edema. Mild thrombocytosis was detected on laboratorial investigation. Patient was treated with a two-day course of oral betamethasone, with clinical improvement. No complications were reported within three weeks of follow-up.
Discussion: AHEI has a sudden onset and a benign, self-limiting course. This report may be a helpful reminder to discriminate AHEI from other, more serious diseases, avoiding exhaustive and unnecessary investigation.

References

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C. Carvalho, G Januário, P Maia, Acute haemorrhagic oedema of infancy. BMJ Case Rep 2013

C. Acun, G Ustundag, A Sogut, R. Koca, G. Numanoglu, A Child Who Has Acute

Onset of Unusual Skin

Lesions and Edema. Pediatrics in Review Vol.27 No.11 November 2006

J. Oliveira, L. Lopes, A Fraga, L. Almeida, B. Aguas, A. Azevedo, Acute Hemorrhagic Edema of Infancy: A Rare Cause of Purpuric Exanthema. J Pediatr 2015;166:498

Published
2019-01-02
Section
What is your Diagnosis?