European Journal of Case Reports in Internal Medicine (Dec 2019)

Purpura Fulminans: a Rare but Fierce Presentation of Pneumococcal Sepsis

  • Adeel Nasrullah,
  • Anam Javed,
  • Usman Tariq,
  • Meilin Young,
  • Zunera Moeen,
  • Marvin Balaan

DOI
https://doi.org/10.12890/2019_001373

Abstract

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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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