Hypersensitivity vasculitis presenting as suspected child abuse: case report and literature review

As awareness of child abuse and neglect increases, children with medical causes for their presenting problems may, on occasion, be initially diagnosed as victims of suspected child abuse. Although a review of the Index Medicus from 1970 to 1978 revealed only two reports of this type of misdiagnosis,1,2 we suspect it occurs frequently. This report describes a child who initially was thought to be battered, but who, in fact, had a vasculitis unrelated to his social problems. CASE REPORT H.P., a 2½-year-old black boy, was seen at the Wyler Emergency Room with unexplained "swelling and bruising all over his body." He was accompanied by his father who appeared intoxicated and gave a changing and confusing history.