Petechiae

You or your child has petechiae (peh-TEE-kee-eye). These are tiny (2 mm) dark red or purple spots on the skin. They are flat on the skin, not raised. They often show up very suddenly. They're often caused by a viral or bacterial infection. They may also be caused by a reaction to a medicine or a collagen disorder. They usually occur on the arms, legs, stomach, and buttocks. They don’t itch. Petechiae that continue to grow and blend together may be caused by a bleeding disorder.

Petechiae caused by an infection or medicine go away on their own without treatment. They don’t leave scars. Scattered petechiae with a fever may be the sign of a very serious infection that needs immediate medical care. If a bleeding disorder is causing the spots, the disorder will need to be treated. You or your child may need more testing for a diagnosis.

Petechiae may be a sign of a serious health condition. So they should always be looked at by a healthcare provider.

Home care

  • Follow any instructions your healthcare provider gives you. This may include changing a medicine that you or your child takes. Don’t start or stop any medicines without talking with your provider.

  • Check the spots regularly for changes. The spots may turn purple as they fade and go away.

  • Contact the provider if you have any questions or concerns.

Follow-up care

Follow up with your healthcare provider, or as directed.

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Your child has a fever (See "Fever and children" below)

  • You have a fever of 100.4°F (38°C) or higher, or as advised by your provider

  • Symptoms get worse

  • The spots increase or get bigger

  • The spots blend together

  • Long streaks appear under nails

  • Bruises get worse or new ones appear that can't be explained

  • Your child shows grouchiness, such as crying that can’t be soothed

  • You or your child becomes lethargic or abnormally sleepy, or does not act like normal

  • Breathing problems

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years old, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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