RSV-induced infantile haemorrhagic oedema (Finkelstein-Seidlmayer vasculitis)

Acute infantile haemorrhagic oedema (AIHE, Finkelstein-Seidlmayer vasculitis) is a leucocytoclastic vasculitis involving small vessels confined to the skin in infants aged 6-24 months. The disease is a benign condition with a dramatic onset characterised by inflammatory oedema in the target or cocard pattern, and ecchymotic purpura in a well (non-toxic) appearing child. It resolves completely spontaneously within 1-3 weeks. Although viral infections have been blamed in the aetiology of AIHE, to our knowledge, there is no reported case of AIHE after respiratory syncytial virus (RSV). In this article, we describe an infant boy with rosette-shaped purpuric skin lesions on the face, trunk and limbs, clinically consistent with the diagnosis of AIHE, with symptoms of upper respiratory tract infection and laboratory investigations revealed RSV infection.