Infantile Acute Hemorrhagic Edema and Rotavirus Infection

Abstract

Infantile acute hemorrhagic edema (AHE) is a benign condition characterized by a dramatic onset of inflammatory edema and ecchymotic purpura in a target or cockade pattern. It is considered an uncommon form of cutaneous vasculitis occurring in children younger than 2 years of age. The outbreak is frequently preceded by an immunization or various infections. We describe an 11-month-old girl with rosette-shaped purpuric plaques on the face and limbs, clinically consistent with a diagnosis of AHE of the skin, associated with fever and diarrhea. Laboratory investigations showed a rotavirus infection, which has not previously been reported in association with AHE of the skin. The disease had a benign course without relapses. Appropriate microbiologic investigations are advisable to confirm the possible etiologic role of rotavirus.

Edema agudo hemorrágico da infância: relato de três casos

“…Staphylococci, streptococci, adenoviruses, Escherichia coli and mycobacteria have also been implicated as probable triggering agents. 1,7 FIGURE 1: Purpuric lesions on the face and right ear The marked characteristic of the disease is the aspect of the lesions, similar to medallions: annular purpuric plaques with well-defined borders and central vascular patterns, located on the face and extremities. The lesions reach up to 5 centimeters in diameter, are not pruritic and a painful subjacent edema is observed mainly on feet, hands, scalp and scrotum.…”

“…1 It was initially described in the United States by Snow, in 1913, under the title of "Purpura, urticaria and angioneurotic edema of the hands and feet in a nursing baby". 2 Since then, some cases have been also reported in Europe, as Finkelstein's Disease and Seidlmayer Syndrome.…”

“…5 Although the cutaneous findings are dramatic and of rapid onset, the prognosis is favorable, with spontaneous resolution within 1 to 3 weeks. 1 The association of fever and purpuric lesions is a challenge to the physician. In the universe of diseases that develop with this association we should art 762 always think of Henoch-Schönlein Purpura, meningococcemia and septicemia, the main differential diagnosis of AHEI.…”

Edema hemorrágico agudo da infância

“…1 The occurrence of IAHE in patients with infections caused by cytomegalovirus and rotavirus was also described. 3,4 The IAHE presents as an acute condition of peripheral inflammatory edema and ecchymotic purpura on the limbs and face. The purpuric lesions are usually large, annular or target-shaped.…”

Macular exanthema in a child with rotavirus gastroenteritis: A case report

“…In developing countries, rotavirus-related diarrhea and vomiting, together, are the major causes of severe dehydration and eventual death in children. [1][2][3] Apart from gastroenteritis, rotavirus has also been implicated with several systemic disorders such as elevated transaminase, 4 convulsion, 5,6 encephalitis, 7 pneumonia, 8 disseminated intravascular coagulation, 9 hemophagocytic lymphohistiocytosis, 10 nephritis in children with immunodeficiency 11 and also with several cutaneous disorders such as generalized maculopapular exanthema, 12 infantile acute hemorrhagic edema 13 and Gianotti-Crosti syndrome.…”