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The Management of fever and petechiae:making sense of rash decisions Brogan PA,Raffles A. Arch Dis Child 2000;83:506-7

Guideline to detect SBS in children with fever and petechiae

derived from cohort of 55 patients

Risk Factors

cap refill > 2 seconds

irritability

lethargy

wbc < 5000 or > 15 000

elevation of CRP > 5 mg/dl

sensitivity 100%, specificity 60%, PPV 20%, NPV 100%, NNT 5

no risk - observe 4 hours

abnormal CRP or WBC but well, IV Antbx x 48 hours

Ill - ICU

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