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Pathological Case of the Month

Guillermo Colantonio, MD; Viviana Kinzlansky, MD; Andrea Kahn, MD; Graciela Damilano, MD
Arch Pediatr Adolesc Med. 1997;151(5):523-524. doi:10.1001/archpedi.1997.02170420093018.
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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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