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Recurrent petechial rashes

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My 15 month old developed petechiae last month. A CBC was ordered, which came back normal. Hematology/Oncology, general peds, and dermatology reviewed his case. They said platelets were a little high, not abnormal, the same with white count. Red blood and iron were a little low, not abnormal. They chalked it up to having a viral cause.
Here we are one month later, and he has it again. This is concerning to me for a couple of reasons.
First, what are the chances that he is still carrying the same virus that caused a petechiael reaction? If it was still there, wouldn't the petechiae have remained constant? Is it common to have recurring episodes? If so, may this just be the way his body will respond to a variety of viruses? I do not want to put him back through the trauma of being hospitalized and poked at again, but am worried. Has a ped appointment tomorrow but am afraid of another "don't know" answer. Petechiae is taking longer to spread/clear this time. NO other symptoms


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replied May 28th, 2009
Toddlers Answer A6681
I see you are concerned with recurrent petechial rashes. You certainly seemed to have had a thorough work-up by appropriate specialists.

I assume the rash is diffuse because a rash only on the face and upper body could be from vomiting, severe coughing, and I have seen this from severe crying with temper tantrums. If so, this would not necessarily require such an extensive evaluation.

Petechiae occurring with normal platelet levels may occasionally occur from a dysfunction of platelet activity that may be caused by drugs, particularly aspirin. I mention this because you state that your child has had reflux and inadvertently Pepto Bismo (a salicylate containing medicine) could have been given. You did not mention as to whether a coagulation work-up, including a factor VIII and a Von Willebrand factor was ordered.

Von Willebrand disease affects about 1% of the population and can rarely present with petechiae.
LJGMD



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