Oral Cues to Disease

4. This 14-year-old girl is concerned about the multiple ecchymoses and thrombi in her mouth. She feels fatigued and has a fever. Her history includes a tendency to bruise easily, menorrhagia, and a recent infection treated with vancomycin. Physical exam is notable for retinal hemorrhages and jaundice.

Diagnosis: Thrombocytopenia purpura may manifest with oral petechiae, purpura, oral hematomas, or hemorrhagic bullae.

For more information, see “Oral lesions you can’t afford to miss.” J Fam Pract. 2015;64(7):392-399.