A 14-month-old male patient came to his health center with fever of up to 39 oC of three days duration, cough, mucus, more frequent liquid stools, without vomiting and lack of appetite.
On physical examination, erythema multiforme with scarce exudate, mucus in cavum, tympanic erythema without other signs and conjunctival erythema without other alterations were observed.
Viriasis is diagnosed and symptomatic treatment is recommended.
Three days later, the patient came to the hospital with purpuric lesions in the lower limbs and ears, and edema in the back of the hands and feet.
She was admitted for five days with the diagnosis of Henoch-Schönlein purpura with blood tests with normal coagulation and urine study (both in acute phase and hematuria in the following two months).
The patient received oral penicillin due to suspicion of a strict etiology. A group A S. pyogenes was found in the throat swab culture.
Nine days after admission, the patient came to the health center with residual purpura lesions without articular edema.
A new pharyngeal smear was performed, which was negative.
