A 4-year-old male child presented with complaints of bruising and swelling on the legs and hands (images provided). History Referred to a family physician with complaints of earache and cough. He was prescribed amoxicillin-clavulanate oral suspension and gentamicin ear drops but did not take the medicines. No other drugs or vaccinations were taken.
Physical examination The patient’s legs and arms are densely packed with several purpuric and ecchymotic lesions. Lesions (1-4 cm in diameter) were elevated from the skin surface. Body temperature - 37.4 0 C Heart rate – 104 beats/min Respiratory rate – 30 breaths/min Blood pressure – 100/60 mm Hg Bodyweight – 18 kg Height – 108 cm Auscultation Prolonged expiration Bilateral crepitant rales Laboratory tests WBC – 18,200/mm 3 (neutrophil, 72%; lymphocyte, 20%; monocyte, 5%; eosinophil, 1%; basophil 1%) Hematocrit – 38% Hemoglobin – 12.9 g/dl…
