Tiny blood vessels (capillaries) link the smallest parts of your arteries to the smallest parts of your veins. Petechiae appear when capillaries bleed, leaking blood into the skin. A number of things can cause this bleeding, including:
- Prolonged straining
- Certain medical conditions
- Specific types of injuries
- Medications
- Injuries and sunburn
Prolonged straining
Tiny petechiae of the face, neck and chest can be caused by prolonged straining during activities such as:
- Crying
- Coughing
- Vomiting
- Childbirth
- Weightlifting
Certain medications
Petechiae may result from taking some types of medications, including:
- Anticoagulants (warfarin, heparin)
- Atropine (Atropen)
- Carbamazepine (Carbatrol, Epitol, Tegretol, others)
- Chloral hydrate (Somnote)
- Desipramine (Norpramin)
- Indomethacin (Indocin)
- Naproxen (Aleve, Anaprox, Naprosyn)
- Nitrofurantoin (Furadantin, Macrobid, Macrodantin)
- Penicillin
- Quinine (Qualaquin)
Infectious diseases
Petechiae may be caused by any of a number of fungal, viral and bacterial infections, including:
- Cytomegalovirus (CMV) infection
- (an infection of the inner lining of the heart)
- Hantavirus pulmonary syndrome
- Meningococcemia
- Mononucleosis
- Rocky Mountain spotted fever
- Scarlet fever
- Sepsis — an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced
- Strep throat
- Viral hemorrhagic fevers
Other medical conditions
Petechiae may also be caused by noninfectious medical conditions. Examples include:
- Vasculitis
- Thrombocytopenia (low platelet count)
- Leukemia
- Scurvy (vitamin C deficiency)
- Vitamin K deficiency
Injuries or sunburns
Child abuse involving strangulation or smothering can cause petechiae in the face and eyes. Biting and spanking can also cause petechiae. Crush injuries, such as those experienced during car crashes, can result in petechiae of the face, neck and chest. Severe sunburn also can sometimes include petechiae.
Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.
- Bennett JE, et al. The acutely ill patient with fever and rash. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed March 10, 2015.
- Hoffman R, et al. Clinical approach to the patient with bleeding or bruising. In: Hematology: Basic Principles and Practice. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. Accessed March 10, 2015.
- AskMayoExpert. Streptococcal pharyngitis (strep) (adult and pediatric). Rochester, Minn. Mayo Foundation for Medical Education and Research; 2014.
- Ely JW, et al. The generalized rash: Part 1. Differential diagnosis. American Family Physician. 2010;81:735. www.aafp.org/afp. Accessed March 10, 2015.
- Nachman RL, et al. Platelets, petechiae, and preservation of the vascular wall. New England Journal of Medicine. 2008;395:1261.
- Fett N. Evaluation of adults with cutaneous lesions of vasculitis. http://www.uptodate.com/home. Accessed March 10, 2015.
- Raffini L. Evaluation of purpura in children. http://www.uptodate.com/home. Accessed March 10, 2015.
- Boos SC, et al. Physical abuse in children: Epidemiology and clinical manifestations. http://www.uptodate.com/home. Accessed March 10, 2015.
- Drews RE. Approach to the adult patient with a bleeding diathesis. http://www.uptodate.com. Accessed March 10, 2015.
- Paulman PM, et al. Bleeding and bruising. In: Signs and Symptoms in Family Medicine. Philadelphia, Pa.: Mosby Elsevier, 2012. http://www.clinicalkey.com. Accessed March 11, 2015.
- Pazirandeh S, et al. Overview of vitamin K. http://www.uptodate.com. Accessed March 10, 2015.
- Hjelle B. Hantavirus cardiopulmonary syndrome. http://www.uptodate.com. Accessed March 10, 2015.
- George JN. Drug-induced thrombocytopenia. http://www.uptodate.com. Accessed March 11, 2015.
- Atropen. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory#labelinfo. Accessed March 11, 2015.
- Norpramin. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory#labelinfo. Accessed March 11, 2015.
- Furadantin. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory. Accessed March 11, 2015.
- Litin SC (expert opinion). Mayo Clinic, Rochester, Minn. March 12, 2015.
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