{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:06:53Z","timestamp":1780358813015,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study investigated febrile children with petechial rashes who presented to European emergency departments (EDs) and investigated the role that mechanical causes played in diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with fever presenting to EDs in 11 European emergency departments in 2017\u20132018 were enrolled. The cause and focus of infection were identified and a detailed analysis was performed on children with petechial rashes. The results are presented as odds ratios (OR) with 95% confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that 453\/34010 (1.3%) febrile children had petechial rashes. The focus of the infection included sepsis (10\/453, 2.2%) and meningitis (14\/453, 3.1%). Children with a petechial rash were more likely than other febrile children to have sepsis or meningitis (OR 8.5, 95% CI 5.3\u201313.1) and bacterial infections (OR 1.4, 95% CI 1.0\u20131.8) as well as need for immediate life\u2010saving interventions (OR 6.6, 95% CI 4.4\u20139.5) and intensive care unit admissions (OR 6.5, 95% CI 3.0\u201312.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of fever and petechial rash is still an important warning sign for childhood sepsis and meningitis. Ruling out coughing and\/or vomiting was insufficient to safely identify low\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16740","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T13:10:35Z","timestamp":1677849035000},"page":"1058-1066","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0685-689X","authenticated-orcid":false,"given":"Benno","family":"Kohlmaier","sequence":"first","affiliation":[{"name":"Department of General Paediatrics Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Leitner","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke N.","family":"Hagedoorn","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics Erasmus MC\u2010Sophia Children's Hospital  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorine M.","family":"Borensztajn","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics Erasmus MC\u2010Sophia Children's Hospital  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"von Both","sequence":"additional","affiliation":[{"name":"Division of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital University Hospital, Ludwig\u2010Maximilians\u2010University Munich  Munich Germany"},{"name":"German Centre for Infection Research, DZIF  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enitan D.","family":"Carrol","sequence":"additional","affiliation":[{"name":"Institute of Infection, Veterinary and Ecological Sciences Liverpool University of Liverpool  Liverpool UK"},{"name":"Alder Hey Children's NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Emonts","sequence":"additional","affiliation":[{"name":"Great North Children's Hospital, Paediatric Immunology, Infectious Diseases &amp; Allergy Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Translational and Clinical Research Institute Newcastle University  Newcastle upon Tyne UK"},{"name":"NIHR Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Trust and Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"van der Flier","sequence":"additional","affiliation":[{"name":"Section of Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases Radboud Institute for Molecular Life Sciences, RadboudUMC  Nijmegen The Netherlands"},{"name":"Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital University Medical Centre Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"de Groot","sequence":"additional","affiliation":[{"name":"Section of Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases Radboud Institute for Molecular Life Sciences, RadboudUMC  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jethro","family":"Herberg","sequence":"additional","affiliation":[{"name":"Section of Paediatric Infectious Diseases Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Levin","sequence":"additional","affiliation":[{"name":"Section of Paediatric Infectious Diseases Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Lim","sequence":"additional","affiliation":[{"name":"Great North Children's Hospital, Paediatric Immunology, Infectious Diseases &amp; 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