PC

Important differential to consider if a child presents with a rapidly-developing non-blanching purpuric skin rash, as well as:

• lethargy

• headache

• fever

• rigors

• vomiting

• Differential diagnoses of a purpuric rash (other than septicaemia)

  • Trauma
  • Liver disease
  • Drugs (e.g., anticoagulants).
  • Vasculitis
  • Thrombocytopaenia
  • Coagulopathy
  • Malignancy
  • Disseminated intravascular coagulation (DIC)

Investigations

• Blood Cultures should be taken immediately

Management

• broad spectrum IV antibiotics should be commenced ASAP
• A senior paediatrician should be notified and review the patient as soon as possible.
• If the patient is seen the community and meningitis is suspected alongside septicaemia, the child should be given immediate intramuscular benzylpenicillin and sent to hospital.