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The management of fever and petechiae: making sense of rash decisions
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  • Published on:
    Making even more sense of rash decisions
    Dear Editor

    In response to the short report of Brogan and Raffles.[1]

    Although studies on children with petechiae who appear clinically unwell are important, the management of such children should pose few dilemmas in deciding to treat for presumed sepsis. A more challenging group is those with petechiae who appear to be well. We feel this group generates anxiety for clinicians who worry about missing occult or ear...

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    Conflict of Interest:
    None declared.
  • Published on:
    Fever and petechiae: Were cases of meningococcal disease missed?
    Dear Editor,

    The accurate diagnosis of meningococcal disease is important, not only for the welfare of the patient, but also for the implementation of appropriate public health measures. Brogan and Raffles have made a useful contribution to more reliable diagnosis.[1]

    However I feel that their finding of 9% could represent a falsely low proportion of children with serious bacteraemia because of potential recru...

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    Conflict of Interest:
    None declared.
  • Published on:
    Fever and petechiae: an ILLNESS
    Dear Editor,

    We read with interest the study and recommendations by Brogan and colleagues (Arch Dis Child 2000;83:506-507). We agree with them on a number of issues and wish to draw attention to the following points.

    (1) Previous international studies do not support a temperature of >37.4oC as an inclusion criteria of significant fever for significant bacterial sepsis (SBS).[1][2] A minimum tempe...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re: The management of fever and petechiae: collaborative studies are needed: Authors reply.

    Dear Editor:

    I was pleased to read the letter from Richards et al proposing a collaberative study to validate the ILL criteria. Firstly, I support this proposal fully.

    I was interested in their statement regarding the ILL criteria in those suspected of having meningococcaemia suggesting that the ILL criteria are of limited use. The abstract they refer to presented at the RCPCH meeting last year[1] state...

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    Conflict of Interest:
    None declared.
  • Published on:
    The management of fever and petechiae: collaborative studies are needed.
    Dear Editor:

    We were interested to read Brogan and Raffles audit of the management of fever and petechiae.[1] This is an important audit for many general paediatricians in the UK. In Newcastle 36% of children with petechiae were treated with antibiotics, only 10% had meningococcal disease (MCD). Brogan and Raffles correctly state that more studies are required to validate their proposed guideline. We offer two such studie...

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    Conflict of Interest:
    None declared.