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Kohlmaier, B; Leitner, M; Hagedoorn, NN; Borensztajn, DM; von, Both, U; Carrol, ED; Emonts, M; van, der, Flier, M; de, Groot, R; Herberg, J; Levin, M; Lim, E; Maconochie, IK; Martinon-Torres, F; Nijman, RG; Pokorn, M; Rivero-Calle, I; Tan, CD; Tsolia, M; Vermont, CL; Zachariasse, JM; Zavadska, D; Moll, HA; Zenz, W, , 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 Paediatr. 2023; 112(5): 1058-1066. Doi: 10.1111/apa.16740
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Leading authors Med Uni Graz: Kohlmaier Benno; Zenz Werner
Co-authors Med Uni Graz: Leitner Manuel
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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 453/34010 (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.
Find related publications in this database (Keywords): febrile illness; mechanical cause of petechiae; meningitis; petechial rash; sepsis