Alvarado Socarras Jorge, Fernandez Velosa Zhirly A
Unidad Neonatal. Fundación Cardiovascular de Colombia. Grupo Organización Latinoamericana para Fomento de la Investigación en Salud (OLFIS).
Salud total EPS, Urbanización El Bosque.
Arch Argent Pediatr. 2017 Dec 1;115(6):e432-e435. doi: 10.5546/aap.2017.e432.
We report a case of acute hemorrhagic edema of infancy in an 18-month-old boy after an episode of otitis media. The clinical presentation begins with skin erythematous macules on the thighs, followed by purpuric lesions in arms, legs, and ankle edema. It was initially interpreted as urticaria, whereby steroids were indicated. However, the clinical feature was acute hemorrhagic edema of infancy, a benign leukocytoclastic vasculitis that occurs in children between 4 and 24 months of age and is characterized by fever, large purpuric palpable target-like skin lesions affecting the face, lobes of the ears, limbs and frequently associated with edema. Differential diagnosis includes erythema multiforme, hemorrhagic urticaria, drug- induced vasculitis, Kawasaki disease, infected eczema, sepsis (either meningococcal or non-meningococcal) and child abuse. Some of them have risk of mortality. Management is conservative, however, steroids may be a therapeutic option.
我们报告了一例18个月大男孩在中耳炎发作后出现婴儿急性出血性水肿的病例。临床表现始于大腿部皮肤红斑，随后手臂、腿部出现紫癜性病变以及踝关节水肿。最初被误诊为荨麻疹，故而使用了类固醇药物。然而，其临床特征为婴儿急性出血性水肿，这是一种良性白细胞破碎性血管炎，发生于4至24个月大的儿童，特征为发热、累及面部、耳垂、四肢的大片可触及的紫癜性靶样皮肤病变，且常伴有水肿。鉴别诊断包括多形红斑、出血性荨麻疹、药物性血管炎、川崎病、感染性湿疹、败血症（脑膜炎球菌性或非脑膜炎球菌性）以及虐待儿童。其中一些病症存在死亡风险。治疗方法较为保守，不过类固醇药物可能是一种治疗选择。
