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Note, if a healthy child with petechiae is evaluated, and the cause is found to be an innocuous cause of the rash (such as an injury without complications), the child should be further observed (some sources say for at least four hours, but it may be longer, particularly if test results take longer than four hours) to ensure other symptoms/complications to not arise. If they look more concerning to you, give me a call or seek medical attention right away. The rash-like red dots which occur in petechiae are not a condition, but rather, a symptom of something else, such as a viral or bacterial infection, a trauma, or other causes. More tests may be ordered after the initial exam and lab tests help to narrow down the possible diagnosis. Spots that are non-blanching (note non-blanching rashes are those that do not disappear after brief pressure is applied to them. Although petechiae may be cause for serious concern (particularly when children have the rash along with a fever), according to Perth Children’s Hospital less than 10% of children with petechiae and fever will be diagnosed with meningitis. The most important thing to keep in mind is that acting quickly to seek professional medical advice can help to improve the prognosis (outcome) of any serious medical complications if they do occur. BMJ. Scratching With Eczema an Lead to Lichen Simplex Chronicus, How Skin Plaques Are Diagnosed and Treated. If fever accompanies petechiae, it could indicate a serious infection. Van Nguyen Q, Nguyen EA, Weiner LB. fbc, CRP can rule out significant bacterial illness on its own. Is it just a rash with no other symptoms you mean? Brogan P, Raffles A. And again, while most rashes are not urgent, as always, if your child has other symptoms that are concerning for something more urgent, please page me. A medical consultation will also rule out serious conditions that may require emergency medical intervention. Haemolytic uraemic syndrome (HUS) For those with associated Medical and nursing staff in the Emergency Department and Acute Care Environments. No single factor, i.e. Blood cultures (if infection is suspected), A lumbar puncture (a small sample of fluid taken from the spine to test for meningitis), Blood coagulation profile (to check normal clotting factors), Urinalysis (to check the urine for bacteria (which may indicate a urinary tract infection) or to check for potential kidney problems. Petechiae is a common rash seen in pediatric emergency departments; this type of non-blanching rash can be of great concern., Often, petechiae are caused by something minor, but it’s important to consult with the pediatrician or healthcare provider anytime petechiae is noted in a child. ). If mild, just treat their other symptoms as you normally would and make sure to keep them away from other children/daycare/etc until I can see them and figure out what their rash is. Please call as early in the day as possible, the more notice we have the easier it is to fit everyone in. The management of fever and petechiae: making sense of rash decisions. Incidence of invasive bacterial disease in children with fever and petechiae. 2016;352:i1285. 4. Fairview Patient Education Petichiae (child). Healthcare providers must perform a thorough exam to evaluate the underlying cause of petechiae. There are many potential underlying causes of petechiae; some of the most common causes include fungal, viral or bacterial infections such as those that cause: Sudden strain can result in the small blood vessels called capillaries to burst and leak into the skin; this appears as red dots that comprise petechiae. Purpuric and petechial rashes in adults and children: initial assessment. If in doubt TREAT AS MENINGOCOCCAL SEPSIS. Make sure you have really good lighting, good resolution, and no blur. Mechanical e.g. Once the above conditions are ruled out clinically, (see individual guidelines for assessment and management), we are left with a differential diagnosis as follows: Evidence is based on retrospective and prospective observational studies, specific points include: Use the following algorithm to help discriminate who needs admission and IV antibiotics and who can be discharged. The Royal Children's Hospital Melbourne. The spots may or may not be palpable (able to be felt) depending on the underlying cause.. Petechiae require prompt medical intervention to screen for medical emergencies. There are a group of conditions which present with a non blanching rash, but have specific features which will identify them easily: Henoch Schonlein purpura (HSP) Idiopathic thrombocytopenia (ITP) Acute leukaemia. Pediatrics 1984; 74:77-80. It often resolves within a week or so without any medication if the affected person has no other symptoms except lesions on the body. Emergency medical treatment should be sought out immediately with any of these symptoms that occur along with petechiae:. J Pediatr 1997;131:398-404. Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor.

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