The differential diagnosis for a petechial rash and purpura is broad. A non-exhaustive list is below. 6 Cause Example(s) Notes Infection Meningococcal septicaemia See below Acute febrile illness +/- fatigue, Endocarditis headache, cough, myalgia/arthralgia and shortness of breath Thrombocytopenia Idiopathic Thrombocytopenia Usually well, multiple bruises (ITP) and petechiae noted over several days Acute Leukaemias Associated with anaemia, lymphadenopathy or hepatosplenomegaly Haemolytic Uraemic Oliguria/anuria associated with Syndrome (HUS) anaemia, usually following a diarrhoeal illness Bone marrow replacement Vasculitis Henoch-Schönlein Purpura Classical distribution of purpura (HSP) and urticaria on buttocks and extensor surfaces, sometimes associated with joint or abdominal pain, proteinuria etc. (See separate HSP guideline) Raised venous Vomiting, coughing, crying Characterised by distribution pressure typically in region of SVC. Trauma Lesions match site of trauma Clotting disorders Haemophilia A Perform clotting screen Haemophilia B Disseminated Intravascular Coagulation (DIC) Vitamin Vitamin K deficiency Confirmed by typical features deficiencies Vitamin C deficiency and low level of the vitamin
The differential diagnosis for a petechial rash and purpura is broad. A non-exhaustive list is below. 6 Cause Example(s) Notes Infection Meningococcal septicaemia Endocarditis See below Acute febrile illness +/- fatigue, headache, cough, myalgia/arthralgia and shortness of breath Thrombocytopenia Idiopathic Thrombocytopenia (ITP) Acute Leukaemias Haemolytic Uraemic Syndrome (HUS) Bone marrow replacement Usually well, multiple bruises and petechiae noted over several days Associated with anaemia, lymphadenopathy or hepatosplenomegaly Oliguria/anuria associated with anaemia, usually following a diarrhoeal illness Vasculitis Henoch-Schönlein Purpura (HSP) Classical distribution of purpura and urticaria on buttocks and extensor surfaces, sometimes associated with joint or abdominal pain, proteinuria etc. (See separate HSP guideline) Raised venous pressure Vomiting, coughing, crying Characterised by distribution typically in region of SVC. Trauma Lesions match site of trauma Clotting disorders Haemophilia A Haemophilia B Disseminated Intravascular Coagulation (DIC) Perform clotting screen Vitamin deficiencies Vitamin K deficiency Vitamin C deficiency Confirmed by typical features and low level of the vitamin
petechial-rash-guideline-for-children-final-version-310117.docx