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What Causes Petechial Rash With Normal Platelet Count?

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Posted on Mon, 28 Dec 2015
Question: My 22 month old son came down with what was though to be petechiae from a virus. His CBC drawn 4 weeks ago was completely normal (platelets, WBC, Hgb ALL normal) but was covered from head to toe in petechiae. They are non blanching pin prick sized reddish purple (some are brownish) spots. 2 weeks after the first CBC was drawn I became concerned because the petechiae weren't going away at all! They maybe were not worse but certainly not any better. Because of this, I took him to see my pediatrician locally and she ordered a repeat CBC w/ diff. This also came back completely normal. Keep in mind he has NO symptoms. No fever, No loss of appetite, and he is acting completely normal. Only odd issue is intermittant diarrhea here and there. Not severe just soft stools maybe once or twice every couple of days but also has some BM that are formed. Ped did an occult stool test and said he had slight traces of C. Diff and E. Coli but nothing major. Because his second CBC came back normal my pediatrician is not concerned. However, now we are going on almost 5 weeks of full body petechiae! Even new petechiae are appearing as the old ones fade so it looks as if he is not getting any better. How can he have petechiae with a normal platelet count? I consulted 3 physicians through this website who were very helpful. One was a pediatrician and the other a hematologist. They both felt there was not real cause for concern due to the 2 normal CBC's.If this is being caused by a virus then how long could a virus last in him and cause this? its been 5 weeks now of petechiae! So I am hoping you can provide me more insight. Also, could a GI infection such as e coli or c diff cause his body to react with petechiae? Thank you.
doctor
Answered by Dr. Shailja Puri (5 hours later)
Brief Answer:
E coli probable cause of infection else skin condition called vasculitis.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
I can very well understand your concern but you can relax.
All normal CBC reports primarily rule out any blood related disorder.
Secondly, a positive stool occult blood test shows presence of blood in stools or dysentery.
Evidence of E coli infection is the probable cause of petechiae.
E coli is bacteria which can lead to infection of urinary tract and gastrointestinal tract.
There are certain strains of E coli which can lead to gastrointestinal infection and bloody diarrhea.
Complications can result in kidney involvement also.
The appearance of petechiae is probably associated with infection with certain strains of E coli.
Since, there is evidence of E coli infection, treatment for E coli is required.
I suggest you to consult your pediatrician for management of the infection.
If the infection has been treated and the petechiae are not improving then I am of the opinion that the petechiae may be due to vasculitis, a disorder of blood vessels not related to blood or any infection.
Thus, you need to consult a dermatologist in that case.
Management will depend on the final diagnosis made after complete work up.

Thanks and take care
Dr Shailja Puri


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Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 9705 Questions

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What Causes Petechial Rash With Normal Platelet Count?

Brief Answer: E coli probable cause of infection else skin condition called vasculitis. Detailed Answer: Hello, Thanks for posting your query on HealthcareMagic. I can very well understand your concern but you can relax. All normal CBC reports primarily rule out any blood related disorder. Secondly, a positive stool occult blood test shows presence of blood in stools or dysentery. Evidence of E coli infection is the probable cause of petechiae. E coli is bacteria which can lead to infection of urinary tract and gastrointestinal tract. There are certain strains of E coli which can lead to gastrointestinal infection and bloody diarrhea. Complications can result in kidney involvement also. The appearance of petechiae is probably associated with infection with certain strains of E coli. Since, there is evidence of E coli infection, treatment for E coli is required. I suggest you to consult your pediatrician for management of the infection. If the infection has been treated and the petechiae are not improving then I am of the opinion that the petechiae may be due to vasculitis, a disorder of blood vessels not related to blood or any infection. Thus, you need to consult a dermatologist in that case. Management will depend on the final diagnosis made after complete work up. Thanks and take care Dr Shailja Puri