Petechiae may be a side effect of drugs like: Phenytoin and valproic acid, which are seizure medications. A blanching rash. Typical clinical findings in HUS include: HUS can appear similar to several conditions including: The treatment of HUS is mainly supportive, the mainstay of treatment is the maintenance of fluid balance and correction of electrolyte abnormalities. Check out the book! Decreased conscious level can be considered an acute neurological emergency characterised by significant brain impairment, necessitating a rapid and methodical approach to evaluation and treatment. Eat fruits and vegetables or take supplements to ensure you get enough vitamins in your diet. Do you or anyone else in your household smoke? Avoid procedures that can lead to skin infections like getting tattoos and piercings. Petechiae are tiny red, flat spots that appear on your skin. Press a glass against a blanching rash and it disappears, you can no longer see it, Press a glass against a non-blanching rash and it doesn't disappear, you can still see it. Here’s How a Mental Health Treatment Plan Can Help, School can be a pain in the back – literally. Blood and immune disorders can also cause petechiae, such as: Hemolytic-uremic syndrome (HUS), a group of blood disorders, Idiopathic thrombocytopenic purpura (ITP), an immune disorder that affects blood clotting, Thrombocytopenia, low levels of platelets that help your blood clot. Is this the first time you’ve had the skin rash? The way to tell if a rash is blanching or non-blanching is to place a clear drinking glass over the rash and press down. More serious diseases such as meningococcal infections, blood disorders, or cancer may need treatment in a hospital. When you visit the health practitioner, he or she may ask you some of the following information about your skin rash: When the doctor/dermatologist examines you, he or she may find the following signs by looking at the skin rash and also feeling the surface of the skin where required. Other components of a routine history should be gone through (past medical history, medical and allergic history - including any over-the-counter drugs - and social history are all relevant). Arrange emergency medical transfer to hospital by telephoning 999. Published by Meningitis Research Foundation;Royal College of Emergency Medicine, 05 September 2018. The rash starts as tiny pinpricks anywhere on the body. Patient.info uses cookies to improve your experience and deliver personalised advertising. The number of infections tends to peak in the, Diarrhoea, which typically turns bloody around day three, Hypertension secondary to acute kidney injury, Small petechiae on the skin can occur due to low platelet count. If we can catch the illness at the stage when it’s just tiny little spots, and treat it with strong antibiotics in hospital, then we can prevent people dying. Scleroderma refers to a group of diseases in which there are changes in the layers of the skin, producing thickened layers, and destruction of hair follicles and sweat glands. Curr Opin Rheumatol. Read about the Ill and Feverish Child. It usually presents with distinctive facial redness, a purple coloured skin rash around the eyes, and swelling. It is therefore very important to be aware of where the rash initially arises from, how it changes or spreads and recognize symptoms and signs that suggest that you should seek medical attention immediately. Stool cultures: to screen for the presence of E.Coli O157. Kumar P, Clark M. Clinical Medicine. If the patient is seen in primary care intramuscular benzylpenicillin can be given whilst awaiting transfer to hospital. They sometimes appear in clusters and may look like a rash. © 2005 - 2020 WebMD LLC. How do you tell the difference? ... Non-accidental injury. Birthmarks. Initial clinical features may be non-specific and include:  Sore throat. Baseline blood tests (FBC, U&E, CRP, clotting): may show thrombocytopenia, raised WCC, anaemia and acute kidney injury. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. Fever (typically greater than 38.3°C). Endocarditis means there’s an infection in the lining of the inner chambers of the heart and the valves. You find it difficult to breathe, your throat is tight, or your face becomes swollen. Tenderness may suggest an inflammatory process. How to tell if an illness is more than just a common cold. What could be causing your pins and needles? But unlike many rashes, when you press on the spots they don't turn white. If it disappears, it is blanching. Everything NICE has said on diagnosing and managing diarrhoea and vomiting caused by gastroenteritis in children under 5 in an interactive flowchart. It can evolve to haemorrhagic bullae and blue-black gangrene. Arrange emergency medical transfer to hospital by telephoning 999. The term 'purpura' describes a purplish discolouration of the skin produced by small bleeding vessels near the surface. No management is needed and the petechiae should self-resolve. Certain distributions of ‘rashes’ should be suspicious for this such as hand marks, linear markings and those on the face/ears. spread of cancer cells. Particular skin rashes may be a manifestation of underlying malignancies. Usually the patient is very unwell, out of proportion to the viral illness.

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