Purpura fulminans secondary to meningococcemia with fatal outcome: A case report and review of the literature

Authors

DOI:

https://doi.org/10.29176/2590843X.1813

Keywords:

purpura fulminans, disseminated intravascular coagulation, thrombosis, infection

Abstract

Purpura fulminans (PF) is an uncommon presentation of meningococcemia secondary to intravascular thrombosis and cutaneous hemorrhagic ischemia. Its course is potentially lethal, with mortality rates in the acute phase between 18-40%. It affects infants more frequently; cases in adults are limited to reports in the literature.

We present the case of a patient with meningococcemia associated with purpura fulminans who required bilateral transtibial amputation and of distal phalanges of both hands.

Author Biographies

Sara Orozco Jiménez, Universidad CES

Residente de Dermatología, Universidad CES, Medellín, Colombia

Olga Lucía Agudelo-Rojas, Universidad CES

Residente de Dermatología, Universidad CES, Medellín, Colombia.

Ana María Mejía-Giraldo, Hospital General de Medellín Luz Castro de Gutiérrez

Médica dermatóloga, Hospital General de Medellín Luz Castro de Gutiérrez, Medellín, Colombia.

Valeria Arciniegas-Grisales, Universidad CES

Residente de Dermatología, Universidad CES, Medellín, Colombia.

References

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Lecuyer, H., Borgel, D., Nassif, X., Coureuil, M. Pathogenesis of meningococcal purpura fulminans. Pathogens and Disease, 2017;75(3). https://doi.org/10.1093/femspd/ftx027.

Williamson, S.J., Ruiz-Gaviria, R. Pneumococcal purpura fulminans in a 25-year-old patient with liver cirrhosis due to autoimmune hepatitis. IDCases. 2022 (30). https://doi.org/10.1016/j.idcr.2022.e01610.

Samman, K., Cathie-Kim, L., Michon, B. An Atypical Case of Idiopathic Purpura Fulminans. Journal of Pediatric Hematology/Oncology. 2022; 44 (8). p 479-481. https://doi.org/10.1097/MPH.0000000000002497

Jover García J, González Cantó J, López Millán C. Púrpura fulminante y síndrome de Waterhouse-Friderichsen asociado a sepsis por Streptococcus pneumoniae en un adulto asplénico. Med Clin Pract. 2018; 1(1-2). p 6–7. https://doi.org/10.1016/j.mcpsp.2018.11.001.

García Cavero E, Barrantes Vargas J, Bravo Puccio F. Lesiones purpúricas y necróticas extensas con compromiso multiorgánico. Dermatol Perú. 2011. 21(2).p 80-86.

Siqueira Batista R, Gomes AP, Dutra Gazineo JL, et al. Meningococcal disease, a clinical and epidemiological review. Asian Pacific Journal of Tropical Medicine. 2017; 10(11). p 1019-1029. https://doi.org/10.1016/j.apjtm.2017.10.004

Pastushenko I, Gracia Cazaña T, Casado Arroyo R. Púrpura y necrosis de rápida instauración en paciente con fiebre. Enferm Infecc Microbiol Clin. 2015; 33(2):129–130. ISSN 0213-005X.

Dinarvand P, Moser KA. Protein C Deficiency. Arch Pathol Lab Med. 2019;143(10):1281-1285. https://doi.org/10.5858/arpa.2017-0403-RS

Coureuil M, Join-Lambert O, Lécuyer H, Bourdoulous S, Marullo S, Nassif X. Pathogenesis of meningococcemia. Cold Spring Harb Perspect Med. 2013;3(6):a012393. Published 2013 Jun 1. https://doi.org/10.1101/cshperspect.a012393

How to Cite

1.
Orozco Jiménez S, Agudelo-Rojas OL, Mejía-Giraldo AM, Arciniegas-Grisales V. Purpura fulminans secondary to meningococcemia with fatal outcome: A case report and review of the literature. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2024 Oct. 29 [cited 2026 Mar. 19];32(4):423-9. Available from: https://revistaasocoldermaorgco.biteca.online/index.php/asocolderma/article/view/1813

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Published

2024-10-29

How to Cite

1.
Orozco Jiménez S, Agudelo-Rojas OL, Mejía-Giraldo AM, Arciniegas-Grisales V. Purpura fulminans secondary to meningococcemia with fatal outcome: A case report and review of the literature. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2024 Oct. 29 [cited 2026 Mar. 19];32(4):423-9. Available from: https://revistaasocoldermaorgco.biteca.online/index.php/asocolderma/article/view/1813
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