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Differential Diagnosis for Petechial Rash on Face after Vomiting

Single Most Likely Diagnosis

  • Viral gastroenteritis: This condition often presents with vomiting and can lead to a petechial rash due to the strain of vomiting causing increased pressure in the small blood vessels of the skin, leading to rupture.

Other Likely Diagnoses

  • Infectious mononucleosis (Mono): Caused by Epstein-Barr virus, it can lead to a rash, including petechiae, especially after the use of certain antibiotics like ampicillin. Vomiting can occur due to the infection itself or secondary to hepatitis or splenomegaly.
  • Allergic reactions: An allergic reaction could cause both vomiting and a petechial rash. This could be due to food, medication, or another allergen.
  • Idiopathic thrombocytopenic purpura (ITP): Although less common, ITP could present with petechiae and potentially with gastrointestinal symptoms like vomiting, especially if there's significant thrombocytopenia.

Do Not Miss Diagnoses

  • Meningococcemia: A life-threatening condition caused by Neisseria meningitidis, which can present with a petechial or purpuric rash, vomiting, and other severe symptoms. Early recognition and treatment are crucial.
  • Thrombotic thrombocytopenic purpura (TTP): A rare disorder of the blood-coagulation system, causing extensive microscopic thrombi to form in the smallest blood vessels throughout the body. Symptoms can include a petechial rash, vomiting, and other systemic signs.
  • Henoch-Schönlein purpura (HSP): Although it typically presents with palpable purpura, abdominal pain, and arthritis, it's essential to consider in the differential due to its potential for severe complications, including gastrointestinal bleeding and renal involvement.

Rare Diagnoses

  • Vasculitis: Conditions like granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) or microscopic polyangiitis could present with a petechial rash and systemic symptoms including vomiting, but these are less common.
  • Disseminated intravascular coagulation (DIC): A condition characterized by both widespread clotting and bleeding in the vascular system, which could potentially cause a petechial rash and vomiting among many other symptoms. It's often associated with severe underlying conditions like sepsis or trauma.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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