Article Text

ACUTE HEMORRHAGIC EDEMA OF INFANCY: REPORT OF A PECULIAR CASE
  1. M Costa1,
  2. J Galhardo1,
  3. V Machado1,
  4. L Felix1,
  5. H Silva1
  1. 1Paediatrics Department, Hospital S. Marcos, Braga, Portugal

Abstract

Background Acute hemorrhagic edema of infancy (AHEI) is an acute cutaneous benign leukocytoclastic vasculitis seen in children ⩽2 years old. The principal differential diagnosis of this pathology is Henoch-Schönlein Purpura. The main differences are: age of appearance, nature of the lesions and minor risk of relapses. Usually there is a previous history of upper respiratory tract infection. AHEI presents with fever, tender edema (face, hands and feet) and purpuric lesions (face and extremities). Platelet count, urinalysis and coagulation study are normal.

The authors’ aim is to describe a typical case of AHEI, to highlight the condition and emphasize its benign nature.

Case report Thirteen month old child that was previously healthy. She had an upper respiratory tract infection 2 weeks earlier. In the ER admission she had purpuric lesions with 24 h evolution, fever and a bloody dejection. The purpuric lesions started in the lower limbs and then affected the face. She appeared well except for the rash. The coagulation study was normal, the platelet count was elevated and E coli was isolated in the urine culture. The purpuric lesions diminished progressively in a few days. There were no relapses.

Discussion AHEI is a clinical diagnosis. It is important to recognize this pathology because despite it having an exuberant clinical presentation, the prognosis is good with spontaneous recovery. The concomitant diagnosis of urinary tract infection makes this case peculiar.

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