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Volume 37, Number 3, June 2004

Diagnosis of Henoch-Schönlein purpura by sonography and radionuclear scanning in a child presenting with bilateral acute scrotum


Li-Hsin Huang, Chun-Yan Yeung, Shyh-Dar Shyur, Hung-Chang Lee, Fu-Yuan Huang, Nien-Lu Wang
Divisions of Allergy and Immunology, and Gastroenterology and Nutrition, Department of Pediatrics, Mackay Memorial Hospital, Taipei; Mackay Junior College of Nursing, Taipei; Taipei Medical University, Taipei; and Divison of Infectious Diseases, Department of Pediatrics, and Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC

Received: July 10, 2003    Revised: October 12, 2003    Accepted: October 25, 2003   

 

Corresponding author:

Dr. Chun-Yan Yeung, No. 92, Sec. 2, Chung-Shan North Road, Taipei, Taiwan 104, ROC. E-mail: cyyeung@ms2.mmh.org.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it



 

Methods:

Acute scrotum presenting as the only initial manifestation of Henoch-Schönlein purpura (HSP) is so unusual that the diagnosis can easily be missed. We report this condition in a 4-year-old boy admitted with bronchopneumonia. Bilateral painful scrotal swelling with ecchymosis occurred on the second day of hospitalization. Scrotal sonography was performed and a good blood supply was documented. Scrotal nuclear scanning was performed and was consistent with bilateral epididymoorchitis. Multiple purpuric lesions over the lower extremities and perineal region developed on the third day of hospitalization. Intermittent abdominal pain and knee pain developed thereafter. HSP was diagnosed and steroids were prescribed. The symptoms subsided gradually and no complication was noted. This case reminds us that an acute scrotum may be the only initial manifestation of HSP. Sonography and nuclear scanning can help rule out other diseases.

 



 

Key words:

Preschool child, Schönlein-Henoch purpura, scrotum, spermatic cord torsion, ultrasonography



 



 

J Microbiol Immunol Infect 2004;37:192-195.