Acute Hemorrhagic Edema of Infancy: Still a Challenge for the Pediatrician

Pediatr Emerg Care. 2018 Feb;34(2):e28-e29. doi: 10.1097/PEC.0000000000000749.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Diagnosis, Differential
  • Glucocorticoids / therapeutic use*
  • Humans
  • Infant
  • Male
  • Pediatricians
  • Purpura / etiology
  • Skin / pathology
  • Vasculitis, Leukocytoclastic, Cutaneous / diagnosis*
  • Vasculitis, Leukocytoclastic, Cutaneous / drug therapy

Substances

  • Glucocorticoids

Supplementary concepts

  • Erythema elevatum diutinum