Quote:
Originally Posted by PedOncoDoc
Petechiae are a sign of defective or insufficient numbers of platelets - distribution is typically in areas where skin is under stress (often at site of shoulder straps, waistline, etc. in those carrying packs). They can be seen from ITP, new onset leukemia, too much aspirin, and several other causes.
ITP would raise the potential for other diagnoses such as new-onset rheumatologic disease (e.g. lupus), underlying immunodeficiency (primary immunodeficiency, undiagnosed HIV, etc.) along with more common ITP causes (e.g. H.pylori, post-viral, etc.)
He could also have aplstic anemia [secondary to a toxic exposure or underlying bone marrow failure syndrome (e.g. Fanconi's anemia, dyskeratosis congenita, etc.) - many of these have hints on the physical examination (leukoplakia, premature graying, short stature, etc.)].
|
Thanks Doc. But I remembered (takes a while sometimes for the connections to be made) why this is important in a patient presenting with a low-grade fever & productive cough. This area of the world is also endemic for what I am thinking and if correct this is a medical emergency and can get ugly fast.
I want to sit back and see what else is revealed from the Hx and PE before I say what I am thinking.
I have only one question when we get to the PE - does the rash blanch when pressed with a glass?
When you say "not really" to the headache question - what does that mean? I take it to mean yes, but low grade. If so, how long?
When did the rash appear? (OK, it was 2 questions)