Petechiae: Pinpoint (1-2 mm) red or purple non-blanching spots on the body Purpura: Larger (> 2 mm) red or purple non-blanching spots on the body Fever: > 38°C in the > 1 month age group > 37.5°C in the < 1 month age group
The cause of petechiae and fever is difficult to diagnose on presentation
Always err on the side of caution and obtain senior medical advice early
This guideline is for Princess Margaret Hospital internal use only
In Australia, most cases of meningococcal disease occur in winter or early spring.
Less than 10% of children with petechiae and fever will have meningococcal disease.
Early recognition and treatment is paramount.
Mortality risk is high at approximately 10%. Furthermore 10-20% of patients who survive will develop permanent sequelae.
Well children with petechiae confined to the area of the distribution of the superior vena cava (SVC) (above the nipple line) are unlikely to have a diagnosis of meningococcal disease.
Consider: investigation and treatment of children who may have received partial treatment with antibiotics