RT Book, Section
A1 Umbrello, Laura
A1 Friedman, Marla J.
A2 Schafermeyer, Robert
A2 Tenenbein, Milton
A2 Macias, Charles G.
A2 Sharieff, Ghazala Q.
A2 Yamamoto, Loren G.
SR Print(0)
ID 1105684755
T1 Petechiae and Purpura
T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 4e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-182926-7
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1105684755
RD 2024/04/23
AB Although  purpura  itself  is  not  dangerous,  it  may  be  a  sign  of  an  underlying  life-threatening  illness  that  requires  immediate  attention.Petechiae  above  the  nipple  line  with  a  history  of  cough  or  vomiting  may  be  benign  and  caused  by  increased  venous  pressure.Purpura  is  present  in  almost  all  patients  with  Henoch–Schonlein  purpura  (HSP),  but  it  may  not  always  be  the  presenting  sign.  This  can  cause  a  delay  in  the  diagnosis.Think  of  idiopathic  thrombocytopenic  purpura  (ITP)  in  a  nontoxic-appearing  child  with  absence  of  splenomegaly  and  a  normal  hemoglobin  and  white  blood  cell  count.Child  abuse  should  be  suspected  if  bruising  occurs  to  nonbony  prominences  or  in  areas  not  normally  subjected  to  injury,  or  if  the  history  is  not  consistent  with  the  physical  findings.