Elling R, Hufnagel M, Henneke P
1_2633Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Mathildenstraße 1, 79106 Freiburg, Deutschland.
2_2633Centrum für Chronische Immundefizienz (CCI), Universitätsklinikum Freiburg, Freiburg, Deutschland.
Monatsschr Kinderheilkd. 2012;160(6):545-555. doi: 10.1007/s00112-012-2633-5. Epub 2012 Jun 10.
A broad spectrum of bacterial, viral, and parasitic infections is associated with hemorrhagic skin lesions, typically petechiae. The most prominent underlying entity is fulminant bacterial sepsis, which requires urgent and intensive treatment. In most cases, however, a self-limiting viral disease is the underlying cause. Thus, the pediatrician frequently encounters a diagnostic dilemma between timely diagnosis of sepsis and unnecessary invasive diagnostics. This article reviews the broad differential diagnosis and pathophysiology of infection-associated hemorrhagic skin lesions and proposes a diagnostic algorithm for the combination of fever and petechiae.
多种细菌、病毒和寄生虫感染都与出血性皮肤病变有关,典型表现为瘀点。最突出的潜在病因是暴发性细菌性败血症,这需要紧急和强化治疗。然而,在大多数情况下,潜在病因是自限性病毒性疾病。因此,儿科医生经常在及时诊断败血症和不必要的侵入性诊断之间面临诊断困境。本文综述了感染相关出血性皮肤病变的广泛鉴别诊断和病理生理学,并提出了一种针对发热和瘀点组合的诊断算法。