Petechiae Are Frequent in Well Babies

Abstract

Epidemiology| July 01 2002 Petechiae Are Frequent in Well Babies AAP Grand Rounds (2002) 8 (1): 9–10. https://doi.org/10.1542/gr.8-1-9 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Petechiae Are Frequent in Well Babies. AAP Grand Rounds July 2002; 8 (1): 9–10. https://doi.org/10.1542/gr.8-1-9 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: petechiae Source: Downes AJ, Crossland DS, Mellon AF. Prevalence and distribution of petechiae in well babies. Arch Dis Child. 2002;86:291–292. To determine the prevalence of petechial spots in well babies, these British investigators examined 116 infants under 12 months of age at child health surveillance clinics in the Sunderland area of Great Britain. The number and location of petechiae (defined as non-blanching red/purple lesions less than 2 mm diameter) and clinical details were recorded by 1 of 2 examiners. A total of 27.6% of babies had 1 or more petechiae, 8.6% had 2 or more, and 2.6% had 3 or more. There was no association of petechiae with preceding viral symptoms in these infants and none of them subsequently developed sepsis. Most of the petechiae (97.5%) were below the neck. The authors conclude that many well infants examined in the community are likely to have petechiae. As these authors point out, “it is clear that sick children with petechiae need to be managed on the assumption that they have meningococcemia.” However, it has not been so clear how we should manage well children with petechiae. These investigators provide useful data that argue for nonintervention in well children. Also, the distribution of petechiae below the neck was common in well infants. The widely held belief that petechiae below the nipple line are indicative of serious disease1 may not hold true in well-appearing infants without fever. This report should reassure pediatricians regarding the presence of 1 or 2 petechiae in a well-appearing, afebrile infant. However, the presence of petechiae in a febrile child represents a different problem altogether. As many as 10% of children with both fever and petechiae have serious bacterial illness.2,3 The presence of petechiae below the nipple line and ill appearance further increase the likelihood that one is dealing with a seriously ill child.1 While 1 or 2 petechiae in a well-appearing, afebrile infant need not prompt an aggressive approach, the child with fever and petechiae should be carefully and thoroughly evaluated for the presence of serious bacterial illness. You do not currently have access to this content.