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Petechiae are small spots, usually purplish red color, visible on the skin and secondary to the micro hemorrhaging of small blood vessels called capillaries under the skin. They are traditionally general lesions suggestive of purpura, a term that defines the existence of subcutaneous hemorrhagic lesions. Lesions can be petechial purpura, ecchymoses but also in a broader form, vibices, kinds of linear streaks. In the case of petechiae, a quick medical consultation is necessary. If they occur in a child with fever and they spread quickly, emergency consultation is necessary because it can be a sign of purpura fulminans, associated with bacterial meningitis.


Petechiae cause no pain or itching, and they manifest themselves only by their particular visual appearance. They are located mainly in the legs, but can occur on all parts of the body. They are bright red, purplish, and usually measure between 1 and 4 mm in diameter. One of their characteristics is not disappearing after a maneuver called vitropression, i.e. when you put pressure on the skin at the level of the lesion.


The diagnosis of petechiae is often clear from the clinical examination, but a test can confirm it. Unlike other skin lesions, petechiae do not disappear with vitropression, which indicates that red blood cells are let out of the blood vessels. In the case of a fever in children and associated significant lesions greater than 3 mm or that grow rapidly, support is urgent, and other tests will be performed after arrival at the hospital. This will include a lumbar puncture and a blood test.


In suspected cases of petechiae related to purpura fulminans, a treatment should be administered urgently. Antibiotics are administered immediately, and a transfer to the hospital under medical supervision is essential. When the cause is not understood after various examinations, another cause of occurrence of these petechiae will be sought and treated specifically.

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