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)

doi:10.1111/apa.16740

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)

Department of Paediatrics

Research output: Contribution to journal › Article › peer-review

11 Downloads (Pure)

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 language	English
Pages (from-to)	1058-1066
Number of pages	9
Journal	Acta Paediatrica
Volume	112
Issue number	5
DOIs	https://doi.org/10.1111/apa.16740
Publication status	Published - 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

Access to Document

10.1111/apa.16740Licence: CC BY-NC-ND

European study confirms the combination of fever andFinal published version, 741 KBLicence: CC BY-NC-ND

Cite this

Kohlmaier, B., Leitner, M., Hagedoorn, N. N., Zavadska, D., & PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union) (2023). European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis. Acta Paediatrica, 112(5), 1058-1066. https://doi.org/10.1111/apa.16740

@article{c76d219e9e1c445eb26767ba11071baa,

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

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.",

keywords = "Petechial rash, febrile illness, mechanical cause of petechiae, meningitis, sepsis",

author = "Benno Kohlmaier and Manuel Leitner and Hagedoorn, {Nienke N} and Borensztajn, {Dorine M} and {von Both}, Ulrich and Carrol, {Enitan D} and Marieke Emonts and {van der Flier}, Michiel and {de Groot}, Ronald and Jethro Herberg and Michael Levin and Emma Lim and Maconochie, {Ian K} and Federico Martinon-Torres and Nijman, {Ruud G} and Marko Pokorn and Irene Rivero-Calle and Tan, {Chantal D} and Tsolia Maria and Vermont, {Clementien L} and Zachariasse, {Joany M} and Dace Zavadska and Moll, {Henriette A} and Werner Zenz and {PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union)}",

note = "Funding Information: This project received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 668303. The research was supported by the National Institute for Health Research Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University. Publisher Copyright: {\textcopyright} 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.",

year = "2023",

month = may,

doi = "10.1111/apa.16740",

language = "English",

volume = "112",

pages = "1058--1066",

journal = "Acta Paediatrica",

issn = "0803-5253",

publisher = "Wiley-Blackwell",

number = "5",

}

Kohlmaier, B, Leitner, M, Hagedoorn, NN, Zavadska, D & PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union) 2023, 'European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis', Acta Paediatrica, vol. 112, no. 5, pp. 1058-1066. https://doi.org/10.1111/apa.16740

TY - JOUR

T1 - European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis

AU - Kohlmaier, Benno

AU - Leitner, Manuel

AU - Hagedoorn, Nienke N

AU - Borensztajn, Dorine M

AU - von Both, Ulrich

AU - Carrol, Enitan D

AU - Emonts, Marieke

AU - van der Flier, Michiel

AU - de Groot, Ronald

AU - Herberg, Jethro

AU - Levin, Michael

AU - Lim, Emma

AU - Maconochie, Ian K

AU - Martinon-Torres, Federico

AU - Nijman, Ruud G

AU - Pokorn, Marko

AU - Rivero-Calle, Irene

AU - Tan, Chantal D

AU - Maria, Tsolia

AU - Vermont, Clementien L

AU - Zachariasse, Joany M

AU - Zavadska, Dace

AU - Moll, Henriette A

AU - Zenz, Werner

AU - PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union)

N1 - Funding Information: This project received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 668303. The research was supported by the National Institute for Health Research Biomedical Research Centres at Imperial College London, Newcastle Hospitals NHS Foundation Trust and Newcastle University. Publisher Copyright: © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

PY - 2023/5

Y1 - 2023/5

N2 - 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.

AB - 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.

KW - Petechial rash

KW - febrile illness

KW - mechanical cause of petechiae

KW - meningitis

KW - sepsis

UR - http://www.scopus.com/inward/record.url?scp=85151082927&partnerID=8YFLogxK

U2 - 10.1111/apa.16740

DO - 10.1111/apa.16740

M3 - Article

C2 - 36866956

SN - 0803-5253

VL - 112

SP - 1058

EP - 1066

JO - Acta Paediatrica

JF - Acta Paediatrica

IS - 5

ER -

Kohlmaier B, Leitner M, Hagedoorn NN, Zavadska D, PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union). European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis. Acta Paediatrica. 2023 May;112(5):1058-1066. doi: 10.1111/apa.16740

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

Abstract

Keywords*

Field of Science*

Publication Type*

Access to Document

Other files and links

Fingerprint

Cite this