Case report
Coxsackie B3 Virus-induced Acute Hemorrhagic Edema of Infancy
Ana Soler-Cardona
; Department of Dermatology, Medical University of Vienna, Vienna, Austria
Adrian Tanew
orcid.org/0000-0002-4433-2790
; Private Dermatological Practice, Vienna, Austria
Sonja Radakovic
orcid.org/0000-0001-6079-9713
; Department of Dermatology, Medical University of Vienna, Vienna, Austria
Abstract
Acute hemorrhagic edema of infancy (AHEI) is a cutaneous leukocytoclastic
small vessel vasculitis of unknown incidence. It affects mostly infants aged
4 to 24 months. The distinctive features of AHEI include a generally healthy-appearing
child with low-grade or absent fever and rarely painful targetoid purpuric
edematous lesions. The disease usually resolves spontaneously within 3 weeks
without late sequelae. The main differential diagnosis of AHEI is Henoch-Schönlein
purpura (HSP). Initially, purpura fulminans should also be ruled out. We report
the case of a 5-year-old girl with low fever and rapidly progressive skin lesions
who had been admitted to the pediatric clinic. The child presented with palpable
annular targetoid and purpuric plaques of different size predominantly affecting
the face and extremities. In addition, there was a painful, hemorrhagic edema on
the dorsum of her hands and feet. Based on the course of the disease and the typical
clinical presentation, i.e., extensive characteristic skin lesions in a young child
in a good general health condition, a diagnosis of AHEI was established. A virus
serology test showed increased titers of enterovirus and coxsackievirus. Isolation
of virus from feces confirmed an infection with coxsackie B3 virus. To our knowledge,
this is the first report linking coxsackie B3 virus infection to AHEI
Keywords
purpura, vasculitis, targetoid hemorrhagic edema, infancy, coxsackie B3 virus INTRODUCTION
Hrčak ID:
274602
URI
Publication date:
15.9.2021.
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