May 1997

Pathological Case of the Month

Author Affiliations

From the Department of Pediatrics, Medical Education and Clinical Research Center, Associated Hospital School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.

Arch Pediatr Adolesc Med. 1997;151(5):523-524. doi:10.1001/archpedi.1997.02170420093018

A 1-YEAR-OLD female infant, healthy prior to admission, was hospitalized for a rash on her face, ears, and lower limbs. The lesions quickly turned purpuric, were target-shaped, and increased in number and size (Figure 1).

Results of a physical examination showed the presence of targetlike petechial ecchymotic lesions on the skin (as large as 4 cm in diameter). Some of the lesions were palpable and localized on the upper and lower limbs, face, and earlobes. No lesions were on the trunk; edema appeared on the dorsa of the hands and feet (Figure 2).

The following probable diagnoses were made: meningococcemia, Henoch-Schönlein purpura, infantile acute hemorragic edema, multiform erythema, or Kawasaki syndrome.

Leukocytes at the time were 18.6×109/L; hematocrit, 0.25; erythrocyte sedimentation rate, 30 mm/h; platelets, 112×109/L; Quick test, 100%; and thromboplastin time test, 35 seconds. Ceftriaxone sodium (100 mg/kg per day) was given for 48 hours

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