ABSTRACT
An 87-year-old woman visited our hospital because of severe widespread purpura with swelling on the right arm. Two days earlier, she had used an electric vacuum cleaner for several hours in order to remove an insect infestation (march flies) in her house. The next day, the purpura expanded to the right chest. Internal medical examination revealed no abnormality except for high levels of myogenic enzymes (lactate dehydrogenase, 326U/L; creatine kinase, 401 IU/L). The electric vacuum cleaner was made in Japan and showed a vibration level of 60dB, which is half that of a chainsaw or lawnmower (120dB). The purpura may have been caused by long-term use of the vacuum cleaner given that the effective value of equivalent vibration acceleration exceeded the European guideline (2.5m/s2 for 8 hours per day).