Bilateral periorbital post-emetic purpura - A case report

Background: Post-emetic purpura is a benign condition characterized by the presence of non-blanchable petechiae or purpura (typically in the distribution of the superior vena cava), usually resulting from a sudden increase in intrathoracic pressure after episodes of vigorous vomiting. Despite its often alarming clinical appearance, which can simulate serious hematologic or infectious diseases, it is a self-limiting occurrence with no systemic implications. Case Presentation: We report the case of a 4-year-old female patient who presented with periorbital purpura after an episode of intense vomiting. Physical examination revealed an erythematous, non-bleachable and bilateral rash that was restricted to the region around the eyes, with no other relevant clinical changes. The condition evolved with spontaneous resolution, without the need for therapeutic interventions. Conclusion: Recognition of post-emetic purpura is essential to avoid additional investigations and reduce anxiety of family members, contributing to a safer and more efficient clinical approach.