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Fever with a purpuric skin rash in children 2021
This document discusses fever with a purpuric skin rash and provides potential diagnoses. It begins by defining rash types and then discusses maculopapular, papular/vesicular, and purpuric rashes. Potential viral, bacterial, and immune-mediated causes are outlined for each rash type. A case scenario describes a child with fever and purpuric rash, for which meningococcal infection is identified as the most likely diagnosis. Details of meningococcal infection, meningococcemia, treatment, and importance of meningococcal vaccination are then provided.
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Fever with a purpuric skin rash in children 2021
- 1. Fever with aPurpuric Skin Rash Diagnosis and Differential Diagnosis Prof. Imran Iqbal Fellowship in Pediatric Neurology (Australia) Prof of Paediatrics (2003-2018) Prof of Pediatrics Emeritus, CHICH Prof of Pediatrics, CIMS Multan, Pakistan
- 2. (God speaking toProphet Muhammad (PBUH) This (the Quran) is a clear statement for all the mankind, and a guidance for those who are conscious of Allah (the pious persons who love Allah and abstain from His disobedience) Al Quran surah Al-Imran 2:138 Al- Quran
- 3. Fever with aSkin Rash • Rash – widespread areas of altered skin • Macule – an area of skin that is altered in color • Papule – elevated solid palpable lesion < 1 cm • Vesicle – fluid-filled lesion < 1 cm • Purpura – bleeding into skin
- 4. Maculopapular Skin Rash withor without Fever Viral Infections • Measles • Rubella • Roseola infantum • Fifth disease • Dengue fever • Entero viruses • Infectious mononucleosis (EB virus) Other causes • Bacterial infections • Scarlet fever • Staphylococcal scalded skin syndrome • Immune-mediated • Allergic Rash • Drug Rash • Erythema multiforme
- 5. Papular or VesicularSkin Rash with or without fever Viral infections • Varicella • Herpes simplex / zoster • Hand-foot-mouth disease • Molluscum contagiosum • Small pox (eradicated) Others • Impetigo • Scabies
- 6. Purpuric Skin Rash withor without fever Infections • Meningococcal infection • Infective endocarditis • DIC Blood / Vascular disorders • ITP - thrombocytopenia • Hemophilia • Acute leukemia • HSP • Vasculitis
- 7. ITP – IdiopathicThrombocytopenic Purpura
- 8. Meningococcal Infection Epidemiology, Etiology ClinicalFeatures, Complications, Management Prognosis and Prevention Prof. Imran Iqbal Fellowship in Pediatric Neurology (Australia) Prof of Paediatrics (2003-2018) Prof of Pediatrics Emeritus, CHICH Prof of Pediatrics, CIMS Multan, Pakistan
- 9. Case scenario • A10 year old child is brought to your clinic with complaint of high grade fever and skin rash for the last three days • On examination, child has a temperature of 101 F. • A Purpuric Rash visible as irregular patches is seen on the body • Child is lethargic What is the most likely diagnosis ?
- 10. Meningococcal Infection • Neisseriameningitides (Meningococcus) is a Gram – ve cocci • Spreads by Droplet Infection in close contact • Infection is common in adolescents • It can cause – • Meningococcemia with purpuric skin rash (DIC) • Meningococcal meningitis • Managed with Antibiotics • Meningococcal diseases have high mortality
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- 12. Prevention • Meningococcal Vaccine(serogroups ACWY) • Given to children, adolescents and adults • Can be administered to children starting at 9 months or at 2 years of age • Should be given to adolescents at 11 – 12 years of age if not given previously • Two doses are given two months apart
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