When little Nicola Schronen of Milnerton Ridge in Cape Town came out in spots a day after a visit to the dentist, her parents had no idea of the nightmare they were facing.
"The doctor wasn't sure what was wrong and when Nicola started running a high fever, she suggested we take her to Milnerton Medi-Clinic," said her father, Johan.
"She was this listless, pale little girl, full of angry red spots."
Nicola, 7, had contracted a seasonal but rare virus, called vasculitis.
According to the medical website MedicineNet.com, vasculitis is a general term for a group of uncommon diseases featuring inflammation of the blood vessels. Effectively, if the blood vessels are inflamed, this could result in the blockage or reduction of blood flow.
In most cases, the cause is unknown. But an allergy to medication and a variety of infections, particularly those associated with hepatitis, can cause small-vessel vasculitis.
Another medical website says it is believed that most forms of vasculitis are a type of auto-immune disease.
The Schronens are sharing the story of Nicola's brush with the disease in a bid to warn other parents that they shouldn't take rashes lightly; they did nothing about Nicola's rash for the first day because they didn't think it was serious.
"It was when her fever started spiking that night that we knew something was not right," said Schronen.
The doctor then referred Nicola to the Medi-clinic.
"The hospital staff did a battery of tests and that night we were told by the cardiologist that they'd picked up a soft or so-called innocent heart murmur.
"This heart murmur is associated with vasculitis and although they weren't 100% sure then, they were aware that this was a viral infection of the vascular system that could attack Nicola's organs, with her kidneys as a primary target.
"My wife Brenda stayed at Nicola's bedside the entire night. We were beside ourselves as her temperature climbed higher and higher. By the early hours she was delirious, crawling around the bed," Schronen said.
Another tense night passed before Nicola was well enough to be discharged.
But it's not over; aside from the rash that still covers Nicola's body, she must see the doctor once a week for tests "so he can watch her kidneys. But we're very glad that her heart is completely fine", Schronen said.
Doctors suggested the medication prescribed for Nicola's tooth abscess may have set off the inflammation.
"We hadn't even heard of this disease before. We really want to warn other parents to be vigilant."
What is it
Vasculitis is hypersensitivity to a drug or foreign agent that leads to inflammation and damage to the blood vessels of the skin.
Symptoms:
- Skin lesions.
- Purpura that can be felt with the fingers.
- Blisters on the skin.
- Hives, which may last longer than 24 hours.
- Open sores or ulcers.
Treatment:
- If possible, stop the medication identified as the problem.
- Aspirin may be prescribed to reduce inflammation of the blood vessels, but children should not be given aspirin.
- Cortico-steroids may be necessary.
Possible complications:
- Permanent damage to the blood vessels or skin.
- Damage of the internal organs, especially the kidneys or bones.
(Information courtesy of Medline Plus, a service of the United States National Institutes of Health.)