Purpura Fulminans: a Rare but Fierce Presentation of Pneumococcal Sepsis

  • Adeel Nasrullah Department of Internal Medicine, Allegheny Health Network; Pittsburgh, USA
  • Anam Javed Department of Internal Medicine, University College of Medicine and Dentistry, Lahore, Pakistan
  • Usman Tariq Department of Internal Medicine, Allegheny Health Network; Pittsburgh, USA
  • Meilin Young Departement of Pulmonology and Critical care, Allegheny Health Network, Pittsburgh, USA
  • Zunera Moeen Department of Internal Medicine, Texas Tech Permian Basin, Odessa, USA
  • Marvin Balaan Departement of Pulmonology and Critical care, Allegheny Health Network, Pittsburgh, USA

Keywords

Purpura fulminans, sepsis, hyperbaric oxygen therapy, Streptococcus pneumoniae

Abstract

Infectious purpura fulminans (PF) is a rare presentation of disseminated intravascular coagulopathy (DIC) due to diffuse intravascular thrombosis and haemorrhagic infarction of the skin. PF can present in infancy/childhood or adulthood and usually presents as ecchymotic skin lesions, fever and hypotension. It is most commonly a consequence of sepsis related to Neisseria meningitidis, Streptococcus pneumoniae or Haemophilus influenzae. Despite aggressive management of sepsis with intravenous fluids, antibiotics, and conventional and nonconventional therapies, the condition still carries a mortality rate of 43%[1]. Streptococcus pneumoniae mostly presents with community-acquired pneumonia. We present a case of PF secondary to DIC related to Pneumococcal sepsis in an otherwise healthy and immunocompetent patient.

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References

  • Andreasen TJ, Green SD, Childers BJ. Massive infectious soft-tissue injury: diagnosis and management of necrotizing fasciitis and purpura fulminans. Plast Reconstr Surg 2001;107:1025–1034.

  • Chalmers E, Cooper P, Forman K, Grimley C, Khair K, Minford A, et al. Purpura fulminans: recognition, diagnosis and management. Arch Dis Child 2011;96:1066–1071.

  • Saraceni C, Schwed-Lustgarten D. Pneumococcal sepsis-induced purpura fulminans in an asplenic adult patient without disseminated intravascular coagulation. Am J Med Sci 2013;346:514–516.

  • Plüß M, Zeisberg M, Müller GA, Vasko R, Korsten P. Therapeutic response to glucocorticoids, anticoagulation and plasma exchange in a patient with primary antiphospholipid syndrome presenting with purpura fulminans. Lupus 2018;27:2170–2173.

  • Cooper JS, Allinson P, Keim L, Sisson J, Schuller D, Sippel J, et al. Hyperbaric oxygen: a useful adjunct for purpura fulminans: case report and review of the literature. Undersea Hyperb Med 2014;41:51–57.
  • Published: 2019-12-30

    Issue: Vol 7 No 1 (view)

    Section: Articles

    How to cite:
    Nasrullah, A., Javed, A., Tariq, U., Young, M., Moeen, Z., & Balaan, M. (2019). Purpura Fulminans: a Rare but Fierce Presentation of Pneumococcal Sepsis. European Journal of Case Reports in Internal Medicine, 7(1). https://doi.org/https://doi.org/10.12890/2019_001373