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Distal Extremity Petechial Rash

Meningococcemia: The classic patient is a child or teenager who acutely develops an intense headache, nausea, vomiting and fever. Meningeal symptoms may occur and the mental state may deteriorate to disorientation or even coma. Hypotensive shock and death may rapidly ensue..

Rocky mountain spotted fever: Prodrome of fever and headache followed by 3-4 days later by a maculopapular rash which begins on the wrists and ankles and spreads to the rest of the body including the palms and soles.

Atypical measles

Typhus and other ricketsial disease, see for example, [Am J Trop Med Hyg. 2010;82;691].

Child with Purpura

Acute Hemorrhagic Edema of Infancy

Henoch-Schonlein Purpura

Purpura Fulminans, e.g. after chickenpox or from sepsis. Or neonatal PF secondary to hereditary deficiencies of clotting factors. e.g. Indian J Anaesth. 2012 May-Jun; 56(3): 283–286.

Scurvy, e.g. Pediatr Rheumatol Online J. 2015; 13: 23.


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