title: Toddler with unexplained multiple bruises.
abstract: It is often very challenging for clinicians to distinguish between accidental, intentional, and other causes of bruising such as underlying bleeding disorder in a child with extensive bruising. We present a case of a 17-month-old healthy male who presented to our emergency department with multiple unexplained bruises after an unwitnessed fall and was subsequently diagnosed with congenital vitamin K-dependent clotting factor deficiency. This case illustrates the importance of thorough assessment in evaluating a child with multiple bruises to differentiate accidental from intentional injuries as well as to recognize bleeding disorders, which warrant specific diagnostic workup.
authors.affiliation: From the Division of Emergency Medicine, Carman and Ann Adam Department of Pediatrics, Children's Hospital of Michigan, 3901, Beaubien Blvd, Detroit, MI.
authors.forename: Rajan
authors.initials: R
authors.lastname: Arora
authors.forename: Earl
authors.initials: E
authors.lastname: Hartwig
authors.forename: Nirupama
authors.initials: N
authors.lastname: Kannikeswaran
mesh_terms: D001778:Blood Coagulation Disorders / Q000150:complications / Q000175:diagnosis*; D003288:Contusions / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D008297:Male; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D014813:Vitamin K Deficiency / Q000175:diagnosis