What is the differential diagnosis for a non-blanchable petechial (small hemorrhagic spots) rash?

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Differential Diagnosis for Non-Blanchable Petechial Rash

Single Most Likely Diagnosis

  • Idiopathic Thrombocytopenic Purpura (ITP): This condition is characterized by low platelet count, leading to petechiae, purpura, and other bleeding manifestations. It is a common cause of non-blanchable petechial rash, especially in children and young adults.

Other Likely Diagnoses

  • Viral Infections (e.g., Mononucleosis, CMV): Certain viral infections can cause a non-blanchable petechial rash, often accompanied by other symptoms like fever, sore throat, and lymphadenopathy.
  • Medication-Induced Thrombocytopenia: Various medications, such as heparin, aspirin, and certain antibiotics, can induce thrombocytopenia, leading to a non-blanchable petechial rash.
  • Vasculitis (e.g., Henoch-Schönlein Purpura): Vasculitis can cause a non-blanchable petechial rash, often accompanied by other symptoms like joint pain, abdominal pain, and renal involvement.

Do Not Miss Diagnoses

  • Meningococcemia: This is a life-threatening condition caused by Neisseria meningitidis, characterized by a non-blanchable petechial rash, fever, and shock. Prompt recognition and treatment are crucial to prevent mortality.
  • Disseminated Intravascular Coagulation (DIC): DIC is a condition characterized by widespread clotting and bleeding, which can cause a non-blanchable petechial rash. It is often associated with severe underlying conditions like sepsis, trauma, or cancer.
  • Thrombotic Thrombocytopenic Purpura (TTP): TTP is a rare but life-threatening condition characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal failure. A non-blanchable petechial rash can be a presenting feature.

Rare Diagnoses

  • Ehlers-Danlos Syndrome: This is a group of genetic disorders that affect connective tissue, leading to easy bruising, petechiae, and other skin manifestations.
  • Scurvy: Vitamin C deficiency can cause a non-blanchable petechial rash, often accompanied by other symptoms like fatigue, malaise, and joint pain.
  • Amyloidosis: This is a condition characterized by the deposition of abnormal proteins (amyloid) in various tissues, leading to a non-blanchable petechial rash and other systemic symptoms.

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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