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


Kohlmaier, Benno, Leitner, Manuel, Hagedoorn, Nienke N, Borensztajn, Dorine M, von Both, Ulrich, Carrol, Enitan D ORCID: 0000-0001-8357-7726, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro et al (show 15 more authors) (2023) European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis. Acta paediatrica (Oslo, Norway : 1992), 112 (5). pp. 1058-1066. ISSN 0803-5253, 1651-2227

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Abstract

<h4>Aim</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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).<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: PERFORM consortium (Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union)
Divisions: Faculty of Health & Life Sciences
Faculty of Health & Life Sciences > Inst. Infection, Vet & Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 17 Mar 2023 10:51
Last Modified: 01 Mar 2026 12:31
DOI: 10.1111/apa.16740
Open Access URL: https://doi.org/10.1111/apa.16740
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3169138
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