Tired purple legs

Author: Jude Okoye, Nirmala Costa-Fernandes / Editor: Fiona Mendes / Codes: HCPS4i / Published: 24/07/2019

A 7-year-old girl presents to the emergency department (ED) after two days of left knee pain and swelling. She had tonsillitis a week ago and has been taking phenoxymethylpenicillin prescribed by her GP.

Today, she started having colicky abdominal pain and passed blood-stained stool.

On examination, of note, she is alert, temperature 37.5 C.
Abdomen – soft, tender in all quadrants, no palpable masses.
Left knee – swollen, warm and tender.
Skin – crops of red-purple lesions, forming a non-blanching rashes on her lower legs and buttocks. (see images)

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