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Fever and Petechiae, Pediatric

Angela M. Statile, MD, MEd and Craig H. Gosdin, MD, MSHA Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Petechiae

    • Small hemorrhages (<3 mm in size) into the superficial layers of the skin

    • Manifest as a reddish purple, macular, nonblanching skin rash

  • Purpura

    • Larger skin hemorrhages (>...

DIAGNOSIS

ALERT

Unsuspected invasive bacterial disease is the most common pitfall in the differential diagnosis of fever and petechiae. A thorough history and physical exam accompanied by laboratory te...

TREATMENT

MEDICATION

  • Empiric antibiotic use should be decided on a case-by-case basis. Due to the high morbidity and mortality of N. meningitidis, the most likely bacterial pathogen in this circumstanc...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Children managed as outpatients:

    • Give instructions to return immediately for progression of rash or worsening illness.

    • Follow-up in 12 to 18 hours

    • ...

ADDITIONAL READING

  • American Academy of Pediatrics. Meningococcal Infections. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2015 Report of the Committee on the Infectious Diseases. E...

CODES

ICD9

  • 780.6 Fever, unspecified

  • 782.7 Spontaneous ecchymoses

  • 287.2 Other nonthrombocytopenic purpuras

ICD10

  • R50.9 Fever, unspecified

  • R23.3 Spontaneous ecchymoses

  • D69.2 Other nonthrombocytopenic purpura

SNOMED

FAQ

  • Q: What are the most common causes of fever and petechiae in children?

  • A: Viruses are the most common overall cause of fever and petechiae in children. The most common invasive bacterial disease ca...

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