Perthes syndrome includes cervical and facial cyanosis, subconjunctival haemorrhage, petechial haemorrhages on the face, neck, and upper chest, secondary to chest compression. We report a clinical case of Perthes' syndrome in 3-year-old boy victims of chest crush by a tractor. Clinical examination found: a Glasgow score at 13/15, polypnea, tachycardia, hypotension; wound of the occipital scalp, a low abundance of hematuria, deformation of the left lower limb. Body scan: bilateral pneumothorax and pulmonary contusions, left hemothorax; lacerations at the medial and upper renal pole grade IV, a low abundance of retroperitoneal hematoma, fracture of the left femur. Biological assessment showed major metabolic disturbances with severe acute rhabdomyolysis and multi-visceral failure. Without clinical improvement, the patient died after 36 hours of intensive care.