Petechiae In Children: Causes, Symptoms And Treatment

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Petechiae in children can be a symptom of an underlying illness or bacterial infection. It results in pinpointed, non-blanching spots less than two millimeters in size that may be caused by blood leakage from the capillaries (tiny blood vessels) to the skin. Petechiae spots often appear on the skin where the body’s mucous membranes are located, such as the arms, stomach, buttocks, and legs. Prompt medical care may be required if your child has a fever with petechial rashes.

Read on to know the symptoms, causes, and treatment of petechiae in children.

In This Article

Causes Of Petechiae In Children

Coughing may lead to petechiae around the neck region

Image: Shutterstock

The causes of petechiae rashes could range from a bacterial, fungal, or viral infection to an underlying blood disorder. Here are some common causes of petechiae in children (1) (2).

  • Viral infections such as enterovirus, Epstein-Barr virus infection, and influenza
  • Cytomegalovirus (CMV) infection
  • Blood disorders such as von Willebrand disease thrombocytopeniaiXMedical condition of having a low blood platelet count , platelet dysfunction, disorders of coagulation, and loss of vascular integrity
  • Other diseases such as dengue fever, Henoch Schonlein purpuraiXA vascular disorder that causes swelling and bleeding of small blood vessels and leukemiaiXAn umbrella term for blood cancer
  • Congenital abnormalities such as Wiscott-Aldrich syndromeiXA genetic immunodeficiency disorder characterized by reduced ability to form blood clots and eczema , Glanzmann thrombastheniaiXA rare, genetic bleeding disorder characterized by prolonged or spontaneous bleeding that starts from birth , and Bernard-Soulier syndromeiX A rare, inherited blood clotting disorder
  • Drug reactions, vitamins C and K deficiency, and chronic liver disease
  • Mechanical causes such as coughing or vomiting, which may cause increased pressure to the upper body and neck regions, leading to petechiae around the neck region
  • Localized physical pressure due to tight stroller straps, car seats, or legs caught in cots
  • Accidental and non-accidental bruising and injuries

protip_icon Point to consider
Petechiae may also be caused due to collagen disorder. However, if the spots keep growing and blending, they may also be due to a bleeding disorder (8).

Symptoms Of Petechiae In Children

Along with the pinpoint rashes, the child may also display other symptoms based on the underlying cause. These symptoms can be grouped into four main types for ease of understanding (3).

1. Unwell children with fever and petechiae

This could be a sign of meningococcal disease, which includes other symptoms such as rashes less than 2mm in diameter, abnormal blood indices such as white blood cells count > 15*10٨9/L and 8mg/L.

Children would be unwell and also show abnormal vital signs such as tachycardiaiXA medical term for having a heart rate above 100 beats per minute , desaturation of air, and increasing systolic to diastolic difference in blood pressure. The child would also have cold extremities, irritability, and lethargy.

2. Well children with fever and petechiae

PurpuraiXSmall, flat purple spots on the skin due to leaking blood vessels under the skin less than 2mm in diameter may indicate meningococcal disease. Rashes mostly seen on the lower limbs and buttocks, with or without arthritis or abdominal pain, could be due to Henoch Schonlein purpura.

3. Petechiae in well children due to mechanical causes

These children do not exhibit any abnormal signs and have a clear history of mechanical causes such as coughing or vomiting, leading to petechiae around the neck region.

4. Well children with petechiae not due to mechanical causes

If the child has fever and petechiae and there are no mechanical causes involved, blood tests must be performed to rule out leukemia. When the child seems well, with a white blood cells count of 5 – 15*10٨9/L, C-reactive protein (3).

protip_icon Be watchful
See a doctor if your child develops long streaks under their nails, bruises that worsen, or breathing problems (8).

Diagnosis Of Petechiae In Children

The doctor may ask about child's symptoms to know the cause

Image: IStock

Your doctor would do a physical examination to identify petechiae and their occurrence on your child’s body. The doctor may also ask questions about other symptoms and the child’s medical history to ascertain the cause behind the rashes.

If the cause cannot be identified, your doctor may prescribe blood or urine tests to understand the underlying cause.

protip_icon Quick fact
The glass test is used to diagnose petechiae. When a drinking glass is firmly placed on the small spots, they don’t blanch (do not disappear) (9).

Treatment Of Petechiae In Children

The treatment depends on the underlying cause. If the rashes do not spread and the child has a normal platelet count, they may not require any specific treatment. However, if there is any sign of abnormality in the tests, your child’s doctor would prescribe an appropriate treatment (2).

  • If the rashes are due to a drug reaction, they will subside on their own once you stop the medication.
  • Antimicrobial therapy may be recommended if the petechiae are due to meningococcal infection (4).
  • In the case of Henoch-Schonlein disease, your doctor might recommend bed rest and elevation of the affected areas. They may also prescribe paracetamol or NSAIDs for mild pain. Steroids are given in the case of moderate to severe pain (5).
  • Chemotherapy or radiation could be the options for cancer.

Home Care Tips For Petechiae

Let your child take adequate rest to help them recover fast

Image: Shutterstock

Along with your doctor’s treatment, you can try some of the tips mentioned below to help your child. However, make sure you talk to your doctor before trying any of these home care tips.

  • If the reason behind your child’s petechiae is due to medications, stop them and observe the rashes every hour to see if they are subsiding or spreading.
  • Help your child take adequate rest. If the rashes are due to a bacterial or viral infection, do not send your child to school as these are highly contagious.
  • Keep them hydrated by giving them fluids such as water and fruit juices.

Prevention Of Petechiae

Apply insect repellent on your child before they step out

Image: Shutterstock

You may not be able to prevent petechiae if the underlying cause is an autoimmune disorderiXDisorders where the body's immune system mistakes healthy tissues for foreign bodies and tries to damage them  or cancer. However, infections and mechanical causes can be prevented by following the tips mentioned below (6).

  • Inform your doctor of any allergies or drug reactions your child might have.
  • Make sure the stroller straps, belts, etc. are not too tight.
  • Keep your child away from family members or people who are sick.
  • Do not share their items, such as glasses or towels, with others.
  • Always apply insect repellent on your child’s body if they are heading to the playground or the woods.
  • Instruct your children to wash their hands before eating and after coming home from the playground.

Frequently Asked Questions

1. Do petechiae always signify leukemia?

No, petechiae and leukemia are not exclusively related (7).

2. When should I be concerned about my child’s petechiae?

If the following symptoms accompany your child’s petechiae, consult your doctor (6):

  • The appearance of red dots on the skin
  • Dizziness
  • Fainting
  • Difficulty breathing
  • Confusion

3. Are there any long-term effects of petechiae in children?

Petechiae is not known to cause complications or long-term effects in children. It usually disappears after a few days, but if it lasts long and spreads all over the body, it is probably caused by an underlying illness, and the condition will resolve when the underlying illness is cured (10).

Petechiae in children is a condition in which they develop red rashes all over their bodies. Depending on the associated symptoms, petechiae can be classified as sick children with fever and petechiae in well children with fever and petechiae, petechiae in well children due to mechanical causes, and petechiae in healthy children due to non-mechanical factors. It’s a typical symptom of various diseases, infections, and allergic reactions. So, if you notice petechiae on your child’s skin, it’s ideal to have it checked and treated as soon as possible.

Infographic: A Quick Overview Of Petechiae In Children

Petechiae in children can sometimes be an indication of an underlying infection. Check out this infographic to know:

  • What exactly is Petechiae
  • What triggers the condition
  • How to prevent it
causes of petechiae in children (Infographic)

Illustration: Momjunction Design Team

Get high-quality PDF version by clicking below.

Download Infographic in PDF version Download Infographic
Download Infographic in PDF version

Key Pointers

  • Petechiae rashes in children are mostly caused by infections or underlying conditions.
  • Seek medical advice if you begin to notice red rashes on your child’s body to avoid further complications.
  • Plenty of rest and fluids and following personal hygiene measures could help prevent this condition.

Petechiae in children could be due to an underlying issue. The experts in this video discuss its causes, symptoms, diagnosis, and treatments.


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