European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis

Benno Kohlmaier, Manuel Leitner, Nienke N Hagedoorn, Dace Zavadska, PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union)

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: This study investigated febrile children with petechial rashes who presented to European emergency departments (EDs) and investigated the role that mechanical causes played in diagnoses.

METHODS: Consecutive patients with fever presenting to EDs in 11 European emergency departments in 2017-2018 were enrolled. The cause and focus of infection were identified and a detailed analysis was performed on children with petechial rashes. The results are presented as odds ratios (OR) with 95% confidence intervals (CI).

RESULTS: We found that 453/34,010 (1.3%) febrile children had petechial rashes. The focus of the infection included sepsis (10/453, 2.2%) and meningitis (14/453, 3.1%). Children with a petechial rash were more likely than other febrile children to have sepsis or meningitis (OR 8.5, 95% CI 5.3-13.1) and bacterial infections (OR 1.4, 95% CI 1.0-1.8) as well as need for immediate life-saving interventions (OR 6.6, 95% CI 4.4-9.5) and intensive care unit admissions (OR 6.5, 95% CI 3.0-12.5).

CONCLUSION: The combination of fever and petechial rash is still an important warning sign for childhood sepsis and meningitis. Ruling out coughing and/or vomiting was insufficient to safely identify low-risk patients.

Original languageEnglish
Pages (from-to)1058-1066
Number of pages9
JournalActa Paediatrica
Volume112
Issue number5
DOIs
Publication statusPublished - May 2023

Keywords*

  • Petechial rash
  • febrile illness
  • mechanical cause of petechiae
  • meningitis
  • ; sepsis

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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