Petechiae - Fairkarts

What Are Petechiae?

Petechiae are small, pinpoint-sized red or purple spots that appear on the skin as a result of minor bleeding under the surface. They often form a rash and can be caused by infections, allergic reactions, or various medical conditions. While commonly seen in children, petechiae may also appear in adults and can show up on areas like the arms, legs, abdomen, and buttocks. These spots can also occur on mucous membranes such as inside the mouth or eyelids. Unlike hives, petechiae do not itch or form raised bumps.

How Petechiae Appear and What They Mean

Key Characteristics of Petechiae

Petechiae are typically:

Flat and non-raised
Red or brownish-red in color
Often appearing suddenly
Clustered in groups resembling a rash
Non-blanching (they don’t fade when pressure is applied)
Commonly found on the extremities, abdomen, buttocks, or mucous membranes

Could Petechiae Signal a Serious Issue?

If petechiae begin to merge into larger patches or spread across the body, it may suggest an underlying bleeding disorder or more serious health condition. Immediate medical evaluation is recommended in such cases.

Common Causes of Petechiae

Infectious Causes

Petechiae may result from various infections, including:

Viral: Influenza, mononucleosis
Bacterial: Streptococcal infections, endocarditis (heart infection), meningococcal disease
Fungal: Less common but still possible in immunocompromised individuals

Chronic Medical Conditions

Underlying health issues that may lead to petechiae include:

Ehlers–Danlos syndrome (EDS): A connective tissue disorder
Liver disease
Autoimmune diseases: Such as lupus (SLE)
Cancer treatments: Radiation therapy or chemotherapy

Lifestyle and Environmental Factors

Physical strain or minor trauma can also result in petechiae:

Heavy lifting
Forceful coughing or vomiting
Childbirth-related pressure
Vitamin deficiencies (especially vitamin C or K)
Skin damage from sunburn or injuries

Medications That May Cause Petechiae

Certain medications are known to list petechiae as a side effect. These include:

Antibiotics: Especially penicillin
Blood thinners: Such as warfarin
SSRIs: A type of antidepressant
Anti-seizure drugs: Such as phenytoin (Dilantin)
NSAIDs: Like ibuprofen
Sedatives and antiarrhythmics: For heart rhythm management
Quinine: Used in malaria treatment

Always consult your doctor before stopping or switching any prescribed medication.

Diagnosing the Cause of Petechiae

What to Expect During a Medical Evaluation

Your healthcare provider will:

Take a thorough medical history
Perform a physical examination
Ask about symptoms such as fever, recent illnesses, or trauma

Common Diagnostic Tests

To identify the root cause, your provider may order:

Complete blood count (CBC): To check platelet and white blood cell levels
Blood cultures: To detect infections
Coagulation studies: To evaluate clotting function
Vitamin level tests
Liver function tests
Urinalysis
Chest X-ray
Lumbar puncture: If meningitis is suspected

When to Seek Immediate Medical Attention

Petechiae can be a sign of a medical emergency, especially when accompanied by:

Fever above 100.4°F (38°C)
Unexplained fatigue or excessive sleepiness
Difficulty breathing
Inconsolable crying in infants
Rash that spreads or changes in appearance

In Children

While petechiae are common in children, less than 10% of cases involving both petechiae and fever result in a diagnosis of meningitis. However, early evaluation is critical.

Treatment for Petechiae

Depends on the Underlying Cause

The treatment for petechiae is not about the rash itself, but what’s causing it. Possible approaches include:

Observation: In cases with no other symptoms
Antibiotics: If caused by a bacterial infection
Adjusting medications: If a drug reaction is suspected
Hospitalization: In severe cases like meningitis or sepsis

Final Thoughts

Petechiae are small, red skin spots that do not itch or fade when pressed. While sometimes harmless and self-limiting, they can also signal more serious conditions like infections or bleeding disorders. If you or your child develops petechiae—especially with other symptoms like fever—it’s essential to seek prompt medical attention.