Author: Fred Smith / Editor: Jessie Lynch / Codes: / Published: 27/11/2024
A 7-year-old girl is bought to the Emergency Department (ED) by her parents concerned about swollen ankles and a rash on her legs. She had begun to complain of pain in her ankles and needed carrying back to the car while out on a walk. When home, the parents noticed purple spots around her ankles and these had spread up her lower legs over the course of the day. (you can view the image of the rash here)
On further enquiry, the patient has no other symptoms but did recently have symptoms of an upper respiratory tract infection.
She has no past medical or surgical history, and is on no regular medications.
On examination:
- Oxygen saturations 98% on air
- Respiratory rate 18 breaths/minute
- Heart rate 90 beats/minute
- Blood pressure 100/70mmHg
- Temperature 36.7 C
Respiratory, cardiovascular and abdominal examinations all unremarkable.
There are palpable purpura and petechiae over her ankles and lower legs which are non-blanching. There are no other areas of rash present. He ankles are slightly swollen, but there is no erythema and there is full range of movement in both ankles. She has mild discomfort when walking.
Urinalysis has been done, which is negative for blood, leukocytes, nitrites and protein.
