RASHES, EDEMA, AND THE DIAGNOSTIC PUZZLE: UNRAVELING ACUTE HEMORRHAGIC EDEMA OF INFANCY IN A 9-MONTH-OLD

Abstract

Acute Haemorrhagic Edema of Infancy (AHEI) is a rare and benign small vessel vasculitis that typically affects children aged 4 to 24 months. Despite its self-limiting nature, AHEI often poses a diagnostic challenge due to its clinical similarity to more severe conditions such as Henoch-Schönlein purpura (HSP), erythema multiforme, Kawasaki disease, and meningococcaemia. The report on the case of a 9-month-old girl who presented with localized swelling and purpuric skin lesions, initially misdiagnosed as cellulitis. The diagnostic challenge was compounded by the rarity of AHEI and its resemblance to other vasculitis and infectious conditions. Following a series of clinical evaluations and a skin biopsy, the diagnosis of AHEI was confirmed. The patient was treated with a short course of oral corticosteroids, resulting in complete resolution of symptoms. The accurate diagnosis of AHEI not only facilitated appropriate management but also prevented unnecessary investigations and alleviated parental anxiety. This case underscores the importance of considering AHEI in the differential diagnosis of infants presenting with purpuric lesions and localized edema. Early recognition and accurate diagnosis are crucial in preventing over-treatment and ensuring optimal patient care.