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1 INTRODUCTION We are all familiar with the surge of viral illnesses that hits emergency departments in winter. Thus, the presenting complaint of a child with a sore throat, fever, and lethargy may not initially spark much concern. This report, however, aims to demonstrate the importance of avoiding cognitive biases when met with seemingly “common” presentations during busy peak seasons.
1 CASE REPORT A previously healthy 5-year-old girl of Middle Eastern heritage presented to the emergency department with spontaneous bruising and well demarcated purpura to her face, extremities, and trunk, sparing the mucus membranes. She had periorbital edema and swelling to her upper arms and thighs which had progressively increased over 2 days (Figures 1-4). The purpuric areas were warm and painful to touch.
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