Perioral petechiae and pulmonary haemorrhage, thinking outside the vacuum.

A 3-month-old boy presented to the children’s emergency department with respiratory distress, haemoptysis, and perioral petechiae ([figure 1][1]). He was pale and floppy, with tachypnoea, hypoxia (SpO2 84%), bilateral crepitations, and wheeze. His white cell count was mildly elevated (20.5 ×109/L