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.
Causes Of Petechiae In Children
- Viral infections such as enterovirus and influenza
- Neisseria meningitidis (meningococcal) bacterial infection
- Blood disorders such as thrombocytopenia, platelet dysfunction, disorders of coagulation, and loss of vascular integrity
- Other diseases such as Henoch Schonlein purpura and leukemia
- Congenital abnormalities such as Wiscott-Aldrich syndrome, Glanzmann thrombasthenia, and Bernard-Soulier syndrome
- 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 injuries
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 < 5*10٨9/L and raised C-reactive protein > 8mg/L.
Children would be unwell and also show abnormal vital signs such as tachycardia, 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
Purpura 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 < 8mg/L, and no change in the state or progression of the rashes over four hours, they are at low risk of meningococcal disease (3).
Diagnosis Of Petechiae In Children
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.
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
- 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
You may not be able to prevent petechiae if the underlying cause is an autoimmune disorder 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
- Difficulty breathing
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
- 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 and purpura with/without fever; Starship Hospital
- Ailbhe McGrath and Michael J. Barrett; Petechiae; StatPearls (2020).
- Petechiae and purpura; The Royal Children’s Hospital Melbourne
- Acute meningococcal disease; The Royal Children’s Hospital Melbourne
- Henoch-Schönlein purpura; The Royal Children’s Hospital Melbourne
- Petechiae; Cleveland Clinic
- Signs and symptoms of leukemia; Moffitt Cancer Center