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Home Health A-Z Petechiae – Symptoms, Causes, Treatment and Prevention

Petechiae – Symptoms, Causes, Treatment and Prevention

Verified By Dr AISHWARYA MALLADI July 29, 2021 15220 0
Petechiae
Petechiae

Overview

Petechiae is a condition in which red spots of 1-2 mm appear on any part of the body. It occurs due to intradermal (between epidermis and hypodermis) capillary bleeding. These spots  are non-blanching as they do not disappear on applying pressure. Both petechiae and purpura are non-blanching spots. Purpura is bigger than the petechiae and  develops due to bleeding within the skin, and its size is more than 2 mm. 

What is Petechiae?

The blood clot is a series of controlled events that require endothelium (exposed), tissue factor, collagen, platelets, platelets activating factors (PAF), prothrombin, fibrinogen, von Willebrand factors (vWF), and other cofactors to work. Platelets are closely associated with regulating pro-angiogenic factors, such as vascular endothelial growth factor (VEGF), angiopoietin 1, etc.  Petechiae, a hemorrhagic lesion that involves excessive bleeding, is a common phenomenon associated with thrombocytopenia. A noticeable decrease in the platelet count (10,000-20,000/cubic millimeter) occurs during thrombocytopenia. It disrupts the whole assembly, the endothelial barrier becomes leaky, and erythrocytes (blood cells) enter the surrounding tissues. This event and disruption of several other physiological events manifest into petechiae (superficial lesions) and purpura (deep lesions). 

Is Petechiae a Rash?

The appearance of petechiae may look like a rash, but it isn’t one. They are pinpoint red dots on the skin developed due to broken blood vessels under the skin. Petechiae is not itchy or painful. When you press on petechiae, it remains purple, red, or brown, whereas a rash turns pale or lighter when applied pressure. 

What Does Petechiae Look Like?

As mentioned above, petechiae appear as flat, pinpoint-sized red, brown, or purple dots. Several petechiae in one place may look like a rash. However, when applying pressure on rashes, they turn pale, but the colour of the petechiae remains the same. If you notice larger, red, or purple spots, it is one of the types of bleeding problems known as purpura.

You may develop petechiae anywhere in the body, sometimes noticed inside the mouth or eyelids.

What Causes Petechiae? 

When the blood vessels break open, the blood leaks into the skin, forming petechiae. The two most common causes are infections and reactions to medications. The other causes include the following:

Possible Cause Additional symptoms and information
Cytomegalovirus (CMV)It is a viral illness with symptoms of fatigue, fever, sore throat, and muscle pain.
EndocarditisWhen the heart’s inner lining gets infected, the patient develops symptoms such as fever, chills, fatigue, joint and muscle pains, breathing difficulties, and pale skin. 
Hantavirus Pulmonary SyndromeA viral infection shows symptoms similar to the flu. The symptoms of hantavirus pulmonary syndrome include breathing difficulties, fatigue, fever, and muscle pain.
InjuriesAny damage to the skin, such as biting, hitting, or a car accident, may cause petechiae. It can also form due to friction against the skin due to carrying a heavy bag or a tight strap of clothing and a sunburn. 
LeukaemiaBone marrow cancer is known as leukaemia. The symptoms of leukaemia include fever, chills, fatigue, unintentional weight loss, swollen glands, bruising, nosebleeds, and night sweats. 
MeningococcemiaA respiratory tract bacterial infection may show signs of fever, headache, muscle pain, and nausea.
Mononucleosis (Mono)Mononucleosis, commonly known as mono, is a viral infection. It is transmitted through saliva and other bodily fluids. The symptoms include fatigue, sore throat, fever, lymph node and tonsils swelling, and headaches.
Rocky Mountain Spotted Fever Ticks transmit the rocky mountain spotted fever. The symptoms include high fever, chills, extreme headache, muscle aches, nausea, and vomiting
Scarlet FeverIf you have recently recovered from strep throat, you are at high risk of developing a bacterial infection known as scarlet fever. Its symptoms include a rash, red scars on the skin, flushed face, red tongue, fever, and sore throat.
ScurvyLack of vitamin-C causes scurvy. Watch for signs such as fatigue, swollen gums, joint pain, breathing difficulties, and bruising.
SepsisThe symptoms of this life-threatening blood infection are high fever, increased heart rate, and breathing difficulties.
StrainingWhen you strain yourself, you cause the blood vessels in the skin to break in the face, neck, and chest. Activities such as crying, giving birth, coughing, lifting weights, or vomiting should be completed without straining too much. 
Strep throatIt is a bacterial infection that causes a sore throat. Watch for symptoms such as fever, nausea, headache, vomiting, body aches, and swelling in the tonsils and glands. 
ThrombocytopeniaIt is a medical condition where you have few platelets that help in a blood clot. If you experience bruising, bleeding from your gums and nose, blood in urine or stool, fatigue, and yellow skin and eyes, meet your doctor at the earliest.
VasculitisYou may suffer from vasculitis when the blood vessels swell, narrow, and scar. The symptoms include fever, headache, fatigue, weight loss, aches and pains, night sweats, and nerve problems.
Viral hemorrhagic feverDengue, ebola, and yellow fever are categorized as viral hemorrhagic fever. These infections make it difficult for your blood to clot. It would be best if you looked for symptoms such as high fever, fatigue, light-headedness, weakness, pains, and bleeding under the skin.

Petechiae By Side effect of certain drugs

There are specific medications that cause side effects resulting in petechiae. The following are medications and their side effects:

MedicationExample
AntibioticsPenicilin, nitrofurantoin
AntidepressantsDesipramine
Antiseizure drugsCarbamazepine
Blood thinnersHeparin, warfarin
Heart rhythm drugs Atropine 
Nonsteroidal anti-inflammatory drugsIndomethacin and naproxen
SedativeChloral hydrate

When to see a doctor?

 If you or your child develops petechia, seek medical advice immediately. It can mean an underlying medical condition that could be severe or mild. The severity of the condition can only be known after a medical diagnosis. You should immediately meet a doctor if you experience the following symptoms: 

  • High fever
  • Breathing issues
  • Confusion
  • Change in consciousness

How to Prevent the Severity of Petechiae?

It is best to visit doctors when you start observing the initial signs and symptoms of petechiae. This will protect your vitals, such as the heart, brain, kidneys, and gut, etc., from being affected.

What are the Remedies Available for Petechiae?

There is no specific remedy or treatment method for petechiae. Petechiae appears due to a disease condition. So, depending on the particular clinical condition, medicines will be prescribed by doctors. 

Some treatment methods or remedies for clinical conditions are:

Disease or deficiencyTreatment/Remedy
Vitamin K deficiencyVitamin K enriched food should be consumed. If a mother is suffering from VKDB, vitamin K shots should be given to the infant.
Immune thrombocytopenic purpura (ITP)The treatment for adults will be as prescribed by doctors. 
Henoch-Schonlein purpuraDoctor may prescribe or suggest non-steroidal anti-inflammatory drugs (NSAIDs) or antibioticsDialysisKeep yourself protected from allergies. 

What are the complications of Petechiae?

Petechia does not cause any complications. However, it could be a symptom of underlying medical conditions that may cause complications, such as 

  • Multiple organ damage, including kidney, liver, spleen, heart, lungs, and other organs
  • Heart issues
  • Infections in other body parts

How To Diagnose Petechiae?

If your child has a fever with petechiae, it can be a sign of a serious infection such as meningococcal disease. Seek immediate medical attention.

The doctor will assess the child for rashes and discuss their symptoms and recently recovered condition. Blood and urine tests may be conducted to determine the petechiae’s cause. Other diseases may also cause this condition. Keep an eye out for the following symptoms:

  • Issues in breathing: If your child has breathing problems and shortness of breath with petechiae, it can indicate a serious heart condition called endocarditis. It is a condition where the lining of the inner chambers of the heart and the valves are infected. 
  • Confusion: When your child is confused and has petechiae, it can be a sign of Rocky Mountain Fever Syndrome – which is caused due to a tick bite.
  • Sudden change in consciousness: diseases such as dengue, yellow fever, lassa, Marburg, and ebola are known as viral hemorrhagic fevers. One of the symptoms of such fevers is changes in consciousness with petechiae. These fevers are commonly found in tropical countries, and doctors have noticed cases of the same in the US from people who have travelled to such countries. 

Call your doctor immediately for any other concerns and questions.

How long does petechiae last?

If you are suffering from an underlying medical condition with petechiae, the petechiae may persist and spread to other parts of the body until the medical condition is not treated. It also depends on the severity of the condition. But if the petechiae develop without any medical condition, it resolves on its own within a few days. 

What are the treatment options available for Petechiae?

When bacterial or viral infection causes petechiae, the skin spots should disappear as soon as the infection is treated. If it is the side effects of the medication, the symptoms should stop once the medication is discontinued. Also, it is important to constantly monitor the spots for change or the number of spots increase, which can indicate a bleeding disorder.

Doctors recommend a treatment plan after thoroughly assessing the cause and other symptoms. The doctor may prescribe the following medications:

  • Antibiotics that treat bacterial infections
  • Corticosteroids to reduce inflammation
  • Immunosuppressants to stifle the immune system, such as azathioprine, methotrexate, and cyclophosphamide
  •  Chemotherapy, biological therapy, and radiation for cancer

You can also complete the following at home:

  • Rest
  • Consume take over-the-counter medications for pain relief
  • Drink plenty of fluids to avoid dehydration

How to treat petechiae at home?

If you develop petechiae, immediately seek medical attention. However, you can try the following home remedies that can help:

  • Cold compression
  • Keep yourself hydrated
  • Nonsteroidal anti-inflammatory drugs 
  • Rest

What is the prevention of petechiae?

Preventing medical conditions is one way to avoid petechiae. However, not all medical diseases are preventable. You need to avoid medication that causes side effects and let your doctor know about it. The other ways to prevent infection that causes petechiae are as follows:

  • Regularly wash your hands with soap and water or use an alcohol-based hand sanitizer. 
  • Avoid sick people
  • Prevent from using glasses, utensils, and other personal items with other individuals
  • Regularly clean countertops and common surfaces
  • Ensure to practice safe sex
  • Before entering a wooded or grassy area, apply insect repellent with DEET, wear a long sleeve shirt and pants, and tuck pants inside your socks. Also, check for ticks when you return home.

Conclusion

Petechiae is an indication (or alarm) for the early (majorly), middle, or late phase (majorly) of a disease. Hence, these small red spots should be taken seriously, as it marks the beginning of a critical condition (if you are not suffering from chronic diseases). So, a person should identify petechiae to prevent severe health ailments.

Frequently Asked Questions (FAQs)

1. What is the main cause of petechiae?

Petechia may be caused due to various infectious and non-infectious medical reasons. It can be due to bacterial, fungal, or viral infections, including the following:

  • Cytomegalovirus infection
  • Endocarditis
  • Meningococcemia
  • Mononucleosis
  • Rocky Mountain Spotted Fever
  • Scarlet fever
  • Sepsis
  • Strep throat
  • Viral hemorrhagic fevers
Other non-infectious medications such as the following:
  • Vasculitis
  • Thrombocytopenia
  • Leukemia
  • Scurvy
  • Vitamin K deficiency

2. What infections cause petechiae?

. It can be due to bacterial, fungal, or viral infections, including the following:

  • Cytomegalovirus infection
  • Endocarditis
  • Meningococcemia
  • Mononucleosis
  • Rocky Mountain Spotted Fever
  • Scarlet fever
  • Sepsis
  • Strep throat
  • Viral hemorrhagic fevers

3. What medications cause petechiae?

The following medications cause petechiae:

  • Antibiotics
  • Antidepressants
  • Antiseizure medications
  • Blood thinners
  • Heart rhythm medications
  • Cholesterol-reducing drugs
  • Nonsteroidal anti-inflammatory drugs

4. Is petechiae life-threatening?

Typically, petechia is a symptom of a medical condition. The medical condition may be mild to life-threatening.

5. What is the difference between purpura and petechiae?

Both are caused due to blood vessels breaking under the skin. Petechiae are pinpoint spots that are red, purple, or brown, whereas purpura is formed in larger areas that can be purple.

6. When should you worry about petechiae?

If your child has petechiae, it can signify a severe illness or medical urgency. Seek immediate medical attention if you notice the following:

  • Confusion, lightheadedness, or loss of consciousness
  • Fever
  • Petechiae that spreads quickly
  • Issues in breathing
Verified By Dr AISHWARYA MALLADI
MBBS, MD (Dermatology), Venereology & Leprology, Consultant Dermatologist, Apollo Hospitals, Health City, Visakhapatnam

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