Nodular Purpura and Intracranial Bleeding due to Late Onset Hemorrhagic Disease of Infancy: A case report

Authors

  • Karim P Manji MUHAS
  • Nicephorus Rutabasibwa
  • Zainab K Manji

DOI:

https://doi.org/10.4314/tmj.v27i1.198

Keywords:

Hemorrhagic disease, pediatrics, Tanzania

Abstract

UHQ, a four -month-old female child, was rushed to the Emergency Medicine Department (EMD) due to severe spontaneous bleeding. This exclusively breast fed child had a history of diarrhea, vomiting and taking broad-spectrum antibiotics over the last two weeks. She developed nodular purpuric spots for about three days prior to the intracranial bleeding. She was unconscious and responding only to pain, and was severely pale. She was transfused with two units of whole blood and underwent a craniotomy for draining the hemorrhage. She was treated with Vitamin K supplements.  Her OFC was 44cm on admission. She was discharged after one week, with OFC 41cm. On follow-up, she is developing normally.

References

Latini G, Quartulli L, De Mitri B, Del Vecchio A, Vecchio C.Intracranial hemorrhage associated with vitamin K deficiency in a breastfed infant after intramuscular vitamin K prophylaxis at birth. Follow-up at 18 months. Acta Paediatr. 2000;89(7):878-80

Manji KP, Azzopardi D. Intracranial hemorrhage due to vitamin K deficiency following gastroenteritis in an infant. J Trop Pediatr 1999; 45: 105-106.

Boujan MM, Sharef KH.Change in hospital protocol regarding the use of vitamin K prophylaxis in newborns following a case of spontaneous subdural hematoma in a previously healthy 40-day-old infant. East Mediterr Health J. 2013;19(5):502-5.

Kaga A, Ohwada T, Uematsu M, Takano T, Kure S. Late vitamin K deficiency bleeding in an infant born at a maternity hospital. Pediatr Int. 2014;56(1):127-8. doi: 10.1111/ped.12265.

Sutherland JM, Glueck I, Gleser G. Hemorrhagic disease of the newborn: breast-feeding as a necessary factor in the pathogenesis. Am J Dis Child. 1967; 113:524-33

Jimenez R, Navarrete M, Jimenez E et al Vitamin K dependant clotting factors in normal breast-fed infants. J Pediatr 1982;100:424-6

Booth SL, Suttie JW. Dietary intake and adequacy of vitamin K. J Nutr. 1998;128(5):785-8

Gahalaut P, Chauhan S. Vitamin k deficiency bleeding presenting as nodular purpura in infancy: a rare and life-threatening entity. Indian J Dermatol. 2013 Sep;58(5):407. doi: 10.4103/0019-5154.117334.

The Standard Treatment Guidelines (STG) of United Republic of Tanzania by Ministry of Health and Social Welfare, Third edition, 2007

Maduhu ZKI, Manji KP, Mbise RL. Perinatal risk factors for neonatal bleeding at the Muhimbili National Hospital Dar-es-salaam. Tanzania. Tanzania Medical Journal . 2002; 19(2) : 13-16

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Published

2017-04-01

Issue

Section

Case Reports

How to Cite

Nodular Purpura and Intracranial Bleeding due to Late Onset Hemorrhagic Disease of Infancy: A case report. (2017). Tanzania Medical Journal, 27(1), 16-22. https://doi.org/10.4314/tmj.v27i1.198

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