Differential Diagnosis for Infant Facial Petechiae
Single Most Likely Diagnosis
- Birth Trauma: Facial petechiae in an infant can often be attributed to the physical stress of delivery, particularly if there was significant pressure on the infant's face during birth. This is a common and usually benign condition.
Other Likely Diagnoses
- Infection: Petechiae can be a sign of infection, including bacterial or viral infections that may cause a rash or other skin manifestations. In infants, infections such as meningitis or sepsis can present with petechiae.
- Allergic Reaction: An allergic reaction to something the infant has come into contact with could potentially cause petechiae, although this would be less common.
- Vitamin K Deficiency: Vitamin K is essential for blood clotting, and a deficiency could lead to easy bruising or petechiae. Newborns are at risk for vitamin K deficiency bleeding due to low vitamin K levels at birth.
Do Not Miss Diagnoses
- Meningitis or Sepsis: These are life-threatening conditions that can present with non-specific symptoms in infants, including petechiae. Early recognition and treatment are crucial.
- Child Abuse: Although unfortunate, child abuse must be considered in the differential diagnosis of unexplained petechiae or bruising in an infant. It is critical to investigate the circumstances surrounding the appearance of petechiae.
- Disseminated Intravascular Coagulation (DIC): A condition characterized by both widespread clotting and bleeding in the vascular system, which can be triggered by severe infection, trauma, or other causes.
Rare Diagnoses
- Henoch-Schönlein Purpura (HSP): A form of vasculitis that affects blood vessels and is characterized by the deposition of immune complexes containing IgA antibodies. It can cause petechiae, purpura, and other symptoms, but is rare in infants.
- Thrombocytopenia: A condition characterized by low platelet count, which can lead to petechiae among other bleeding manifestations. This could be due to various causes, including immune thrombocytopenia or congenital thrombocytopenia.
- Leukemia: Although extremely rare in infants, certain types of leukemia can present with petechiae due to bone marrow failure and subsequent thrombocytopenia or coagulopathy.