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Case Reports
. 2012:2012:508503.
doi: 10.1155/2012/508503. Epub 2012 Jan 26.

Purpura Fulminans Secondary to Streptococcus pneumoniae Meningitis

Erick F Alvarez  1 , Karen E Olarte, Mayur S Ramesh
Affiliations
Case Reports

Purpura Fulminans Secondary to Streptococcus pneumoniae Meningitis

Erick F Alvarez et al. Case Rep Infect Dis. 2012.

Abstract

Purpura fulminans (PF) is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory signs of disseminated intravascular coagulation (DIC). Our case describes a 37-year-old previously healthy man who presented with 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory workup revealed DIC without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF) biochemical analysis. There was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealed Streptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients with otherwise unexplained DIC as this may be an early manifestation of infection. PF is a clinical diagnosis that requires early recognition and prompt empirical treatment, especially, in patients with progressive altered mental status, ecchymotic skin rash, and DIC.

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Figures

Figure 1
Figure 1
Ecchymotic nonblanching macular lesions on the hand.
Figure 2
Figure 2
Ecchymotic nonblanching macular lesions on the lower extremity.
Figure 3
Figure 3
Ecchymotic nonblanching macular lesions on the foot.
See this image and copyright information in PMC

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