Recurrent single-organ cutaneous small-vessel vasculitis with streptococcal infection in a pediatric patient: A case report

Single-organ cutaneous small-vessel vasculitis is a specific type of vasculitis. Its recurrence rate is approximately 10%, and it is a serious health issue that can lead to increased healthcare costs. There have been no reports of successful treatment of recurrent necrotizing single-organ cutaneous small-vessel vasculitis in children. We report the case of an 11-year-old Chinese girl who presented with recurrently elevated anti-streptococcal O titers and worsening cutaneous necrosis of the lower extremities. She was diagnosed with streptococcal infection-related recurrent severe single-organ cutaneous small-vessel vasculitis and was successfully treated using a "cocktail" therapy, including antibiotics, plasma exchange, and immunosuppressants. She was followed up for 4 years with no recurrence. In conclusion, recurrent necrotizing single-organ cutaneous small-vessel vasculitis in children can be successfully treated with a "cocktail" therapy containing plasma exchange.