Diagnostic and treatment dilemmas in well children with petechial rash in the emergency department
Intended for healthcare professionals
Evidence and practice    

Diagnostic and treatment dilemmas in well children with petechial rash in the emergency department

Andriana Summers Doctor, Emergency Department, Airedale General Hospital, Airedale NHS Foundation Trust, Keighley, West Yorkshire, England

Why you should read this article:
  • To be aware of the differential diagnoses associated with petechial rash before initiating treatment for invasive meningococcal disease

  • To recognise the value of a tailored approach to the investigation, treatment and discharge of well children with petechial rash in the emergency department (ED)

  • To avoid over investigation and overtreatment of well children with petechial rash in the ED

This article presents a discussion based on a case study of an eight-month-old boy with petechial rash who presented at the emergency department (ED). Blood tests were obtained and intravenous antibiotics were administered. The patient was admitted to the children’s ward and was discharged the next day. It was suspected that the rash was caused by a non-specific viral illness.

Non-blanching rashes, such as petechial rash, in well children often lead to diagnostic and treatment dilemmas in the ED. Clinicians fear missing the diagnosis of invasive meningococcal disease, which results in blood tests, cannulation and early administration of antibiotics. Non-blanching rashes have many potential causes and extensive tests and antibiotic treatment may not always be necessary and have the potential to cause harm. A tailored approach to investigate, treat and discharge well children with petechial rash from the ED is advocated.

Emergency Nurse. doi: 10.7748/en.2022.e2138

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Correspondence

andromishka@yahoo.co.uk

Conflict of interest

None declared

Summers A (2022) Diagnostic and treatment dilemmas in well children with petechial rash in the emergency department. Emergency Nurse. doi: 10.7748/en.2022.e2138

Published online: 31 August 2022

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