Incidence of invasive bacterial disease in children with fever and petechiae

The records of 129 patients admitted to the hospital with the findings of fever and petechiae were reviewed to determine the incidence of invasive bacterial disease in patients with this symptom complex. Twenty-six patients (20.2%) had culture-proven bacterial infections; 13 (11.1%) of the group had Neisseria meningitidis, eight had Haemophilus influenzae type B. No single laboratory test was sufficiently sensitive to detect all patients with life-threatening bacterial infections, but a combination of normal laboratory findings was highly specific for those without significant disease.