Toddler with unexplained multiple bruises

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..