Case Of Acute Hemorrhagic Edema Research Articles

A case of acute hemorrhagic edema of infancy

A case of acute hemorrhagic edema of infancy

Acute Hemorrhagic Edema of Infancy

We report a case of acute hemorrhagic edema of infancy (AHEI) occurred in an 11-month-old male infant after upper respiratory tract infection. The onset was dramatic with petechiae, ecchymosis, and annular, nummular, or targetoid purpuric plaques on the extremities, face, and ears. Acute hemorrhagic edema of infancy is a benign form of leukocytoclastic vasculitis that typically affects children between 4 and 24 months of age. The etiology remains still unknown. The potential triggers of AHEI include preceding bacterial or viral infections, immunizations, and drugs. Although the clinical picture is fearful, in the majority of cases, it involves only cutaneous small vessels. Recognizing this as a distinct clinical entity allows to establish an appropriate prognosis for this rare benign disease in children.This report could be a helpful reminder, especially for emergency physicians, to discriminate AHEI from other more severe diseases, such as meningococcal sepsis.

Œdème aigu hémorragique du nourrisson associé à une infection à Coxsackie virus

Acute hemorrhagic edema of infancy is a rare but benign vasculitis occurring in infants aged from 4 to 24 months. Skin lesions can take various forms, including extensive hemorrhagic purpura, and can therefore be mistaken for purpura fulminans if associated with fever, which leads to initiating broad-spectrum antibiotic treatment. In the present case, we describe a 7-month-old boy with acute hemorrhagic edema of infancy and rapidly extensive purpura lesions that led to intravenous cefotaxime and amikacin treatment. Diagnosis was made on the next day by a dermatologist, based on the typical aspect of skin lesions, hemodynamic stability, and negative bacteriological samples. Coxsackie virus B5, a pathogenic enterovirus, was found by specific PCR in cerebrospinal fluid. The outcome was spontaneously favorable after discontinuation of antibiotics on day 2. We discuss the imputability of the enterovirus in triggering this case of acute hemorrhagic edema of infancy.

On Target: A Case of Acute Hemorrhagic Edema of Infancy

Case: A 16-month-old female presented to a referring emergency department with a 2-day history of a progressive rash and swelling that started on her right lower extremity and spread to her upper extremities, trunk, and face (Fig 1). The patient had recently been hospitalized at the referring hospital for bronchiolitis caused by respiratory syncytial virus and was being treated with amoxicillin for otitis media. Her mother had stopped the antibiotic 1 day before presentation after development of a rash and had given the patient diphenhydramine, with no improvement. The patient had a fever with the preceding illness but on admission to the emergency department was afebrile. She had received hepatitis B and diphtheria-tetanus-acellular pertussis vaccines at her 15-month well-child examination 3 weeks before the onset of the rash. The patient had 1 day of decreased oral intake and decreased urine output and a 2-day history of loose stools. Family history is significant for multiple maternal family members with reaction to penicillin causing hives and edema. At the referring hospital, intraosseous (IO) access was obtained after multiple attempts to place intravascular access were unsuccessful, secondary to diffuse body edema. In our emergency department, the medical team attempted to obtain intravascular access with ultrasound guidance; however, they were also unsuccessful because of the patient’s persistent edema. The patient received normal saline via the IO line in addition to oral acetaminophen and diphenhydramine. FIGURE 1 A 16-month-old female with rash and swelling. Physical examination revealed a fussy but consolable, well-nourished toddler with diffuse body edema, scratching at her arms and thighs. She was afebrile, tachycardic to 134 beats per minute, and hypertensive to 126/97 mm Hg. Erythematous annular lesions surrounded the patient's …

10-Year-Old Girl with Severe Edema Caused by Adder Bite

We report a case of acute hemorrhagic edema in a 10-year-old girl caused by adder bite. Therapy consisted of analgesics, antihistamines, corticosteroids. Antivenum serum was applied in a single dose due to severe spreading of the edema. The patient recovered almost completely after 10 days of treatment.

Acute hemorrhagic edema of infancy with abdominal pain and elevated transaminases

Acute hemorrhagic edema of infancy is a rare type of leukocytoclastic vasculitis characterized by a triad of fever, edema, and rosette-shaped purpura, mainly over the face, auricles, and extremities in a nontoxic infant. Visceral involvement is infrequent in acute hemorrhagic edema of infancy. We report a case of acute hemorrhagic edema of infancy with abnormal liver function tests and abdominal pain.

Edema hemorrágico agudo del lactante

Background: Acute hemorrhagic edema of infancy (AHEI) is a cutaneous small vessel leukocytoclastic vasculitis characterized by purpuric plaques and edema of limbs, in a healthy infant. Clinical presentation consists in a recent history of upper respiratory tract infection and/or use of antibiotics or immunizations that triggers an immunologic response mediated by immune complexes. The main differential diagnosis is Schonlein-Henoch Purpura and it is a benign self-limited disease. Objective: To inform about this disease and therefore increase its diagnosis. Case Report: An 8 months-old healthy infant with edema and purpura in the face and limbs, associated with respiratory disease. Laboratory exams were normal and skin biopsy was compatible with AHEI. He didn’t receive any specific treatment and the disease improved spontaneously without recurrence. This child presents a typical case of acute hemorrhagic edema of infancy. Although it is unfrequent, skin manifestations are alarming and can mistake the diagnosis.

Acute hemorrhagic edema of childhood: An unusual variant of leukocytoclastic vasculitis

A case of acute hemorrhagic edema in a 3-year-old boy is presented. Its cause, differential diagnosis, and relation to Schönlein-Henoch purpura are discussed. Acute hemorrhagic edema is an unusual variant of leukocytoclastic vasculitis.