An 11-month-old female presented with swelling of the right side of her face, both hands and feet, and a skin eruption since two hours. No history of trauma, insect bites, fever, drug administration or allergies was reported. The child was vaccinated according to Swiss guidelines.
Well appearing child (normal eye contact with ability to recognize parents or to interact with persons or objects in the environment, absent cyanosis or pallor, absent coldness of the extremities with capillary refill ≤2 seconds in “warm” environment, respiratory rate neither increased nor decreased), body rectal temperature 37.4°C, oxygen saturation 94%, heart rate 110 bpm. Tender, non-pitting edema of right side of the face, both hands and feet, and palpable, non-blanching round-shaped skin lesions on limbs. Remaining examination was normal.