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Purpura fulminans

Ikue Okamura, Yukitsugu Nakamura, Yuka Katsurada, Ken Sato, Takashi Ikeda, Fumihiko Kimura
Purpura fulminans (PF) is a life-threatening syndrome comprising progressive hemorrhagic necrosis due to disseminated intravascular coagulation and dermal vascular thrombosis that leads to purpura and tissue necrosis. Various therapies have been used to arrest the progression of this disease, however, there is no established treatment because of the variety of underlying causes. We herein present an adult case of PF associated with leukocytoclastic vasculitis triggered by antibiotic (levofloxacin) intake. As a result of our rapid and accurate identification of the underlying cause, corticosteroid therapy successfully repressed the inflammatory process...
2016: Internal Medicine
Cristina Hotoleanu
Genetic risk factors predispose to thrombophilia and play the most important etiopathogenic role in venous thromboembolism (VTE) in people younger than 50 years old. At least one inherited risk factor could be found in about half of the cases with a first episode of idiopathic VTE.Roughly, genetic risk factors are classified into two main categories: loss of function mutations (such as deficiencies of antithrombin, protein C, protein S) and gain of function mutations, (such as prothrombin mutation G20210A, factor V Leiden)...
September 17, 2016: Advances in Experimental Medicine and Biology
Andrew J Hale, Mary LaSalvia, James E Kirby, Allison Kimball, Rachel Baden
Asplenic patients are at increased risk for sepsis and fulminant infection. Sepsis in these patients is typically secondary to encapsulated bacteria, with Streptococcus pneumoniae being the most frequent pathogen. Rare complications of severe sepsis include purpura fulminans and bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). We present the case of a 36-year-old woman, healthy except for splenectomy years prior for idiopathic thrombocytopenic purpura treatment, who presented with fever. Upon presentation to our hospital, three hours after symptoms onset, she had purpura fulminans and shock...
2016: IDCases
B S Kalal, P Puranik, S Nagaraj, S Rego, A Shet
BACKGROUND: Rickettsial infections are re-emerging. In India, they are now being reported from several areas where they were previously unknown. OBJECTIVES: The objective of this study was to describe the epidemiology, clinical profile and outcome of serologically-confirmed scrub typhus and spotted fever among children in a tertiary care hospital in Bengaluru. MATERIALS AND METHODS: Hospitalised children aged <18 years, with clinical features suggestive of rickettsial disease admitted between January 2010 and October 2012 were included prospectively...
July 2016: Indian Journal of Medical Microbiology
L Gottrand, F Devinck, V Martinot Duquennoy, P Guerreschi
Physical, non-painful processes guide the scar reshaping in children in order to prevent growth anomalies due to cutaneous shrinkage. The objective of the surgical treatment, coordinated with the reeducation care, is to improve the physical abilities of the skin, to restore the function and avoid the deformations. Reeducation uses various techniques (i.e. sensitive-motility, massage and mobilizations) with or without physical agent (water, aspiration and touch-drive technique). Posture and positioning rely on the small or major aids, from orthosis to prosthesis...
October 2016: Annales de Chirurgie Plastique et Esthétique
Elena Capel, Aldert L Zomer, Thomas Nussbaumer, Christine Bole, Brigitte Izac, Eric Frapy, Julie Meyer, Haniaa Bouzinba-Ségard, Emmanuelle Bille, Anne Jamet, Anne Cavau, Franck Letourneur, Sandrine Bourdoulous, Thomas Rattei, Xavier Nassif, Mathieu Coureuil
UNLABELLED: Neisseria meningitidis is a leading cause of bacterial meningitis and septicemia, affecting infants and adults worldwide. N. meningitidis is also a common inhabitant of the human nasopharynx and, as such, is highly adapted to its niche. During bacteremia, N. meningitidis gains access to the blood compartment, where it adheres to endothelial cells of blood vessels and causes dramatic vascular damage. Colonization of the nasopharyngeal niche and communication with the different human cell types is a major issue of the N...
2016: MBio
Lara Nicolas, Joseph Philip, Shawn Larson, Saleem Islam, Judy F Lew, Frederick L Glavin, Ravi S Samraj
No abstract text is available yet for this article.
July 22, 2016: Clinical Pediatrics
Rwituja Thomas, Preeti Puranik, Bhuvanesh Kalal, Carl Britto, Savitha Kamalesh, Sylvan Rego, Anita Shet
INTRODUCTION: Rickettsial infections are re-emerging in the Indian subcontinent, especially among children. Understanding geographical and clinical epidemiology will facilitate early diagnosis and management. METHODOLOGY: Children aged <18yrs hospitalized with clinically-diagnosed rickettsial fever were reviewed retrospectively. Frequency distributions and odds ratios were calculated from tabulated data. RESULTS: Among 262 children hospitalized between January 2008-December 2012, median age was five years, and 61% were male children...
2016: Journal of Infection in Developing Countries
Keshavmurthy A Adya, Arun C Inamadar, Aparna Palit
Anticoagulants are the cornerstone of treatment of venous thromboembolism associated with various medical conditions and surgical procedures. They act on different steps of the coagulation pathway and are broadly categorized into heparins, vitamin K antagonists, and inhibitors of thrombin and factor Xa. The classification is evolving as newer and better oral and parenteral anticoagulants are being added. Anticoagulants in dermatology are important not only for their therapeutic application in cutaneous thrombotic dermatoses such as livedoid vasculitis, purpura fulminans, superficial and deep venous thrombosis and others but also for their use in non-thrombotic dermatoses such as lichen planus, recurrent oral aphthosis, chronic urticaria and several others...
June 16, 2016: Indian Journal of Dermatology, Venereology and Leprology
Monoj Kumar Konda, Stephanie Chang, Mathew Zaccheo
A 75-year-old woman was admitted into the intensive care unit, with severe sepsis and renal failure. She developed purpura fulminans (PF) of bilateral upper and lower extremities along with gangrene on the tips of her fingers and toes. Blood cultures confirmed Pasteurella multocida as the causative organism. Despite aggressive supportive measures, the patient remained dependent on high doses of vasopressors and the gangrene progressed. She ultimately succumbed to her underlying severe sepsis. PF is a rare and fatal dermatological emergency commonly seen in children, but it also occurs in adults...
2016: BMJ Case Reports
L Pasquesoone, A Belkhou, L Gottrand, P Guerreschi, V Duquennoy-Martinot
Purpura fulminans is a pediatric life-threatening emergency with a significant mortality, combining: septic shock, extensive purpuric lesions and disseminated intravascular coagulation. The most frequent bacterial pathogen is the meningococcus. The medical management includes antibiotics, corticoids, vascular filling and catecholamines. Purpura fulminans is characterized by the extent of hemorrhagic and mainly thrombotic lesions, attributed to the alteration in the vascular endothelium functions. Damage of soft tissues combines large necrotic areas and more or less extensive distal ischemic lesions...
June 8, 2016: Annales de Chirurgie Plastique et Esthétique
A Audemard-Verger, E Descloux, D Ponard, A Deroux, B Fantin, C Fieschi, M John, A Bouldouyre, L Karkowsi, G Moulis, H Auvinet, F Valla, C Lechiche, B Davido, M Martinot, C Biron, F Lucht, N Asseray, A Froissart, R Buzelé, A Perlat, D Boutboul, V Fremeaux-Bacchi, S Isnard, B Bienvenu
Complement system is a part of innate immunity, its main function is to protect human from bacterial infection. As genetic disorders, complement deficiencies are often diagnosed in pediatric population. However, complement deficiencies can also be revealed in adults but have been poorly investigated. Herein, we describe a case series of infections revealing complement deficiency in adults to study clinical spectrum and management of complement deficiencies.A nationwide retrospective study was conducted in French university and general hospitals in departments of internal medicine, infectious diseases enrolling patients older than 15 years old who had presented at least one infection leading to a complement deficiency diagnosis...
May 2016: Medicine (Baltimore)
Ravi Shah, Patrick Ferreira, Shelina Karmali, Doan Le
Subcutaneous (SC) protein C (PC) was used in a child with purpura fulminans secondary to severe congenital PC deficiency. For maintenance, PC 80-120 IU/kg, given over 60-90 min SC Q48hr, has been successful as a home therapy for more than 3 years. The treatment was monitored by measuring trough PC chromogenic activity (target ≥15%) and D-dimer levels. No change in clinical course was appreciated after discontinuing enoxaparin (and leaving the patient on prophylactic PC replacement alone). A significant discrepancy between clotting-based and chromogenic-based PC activity is shown...
August 2016: Pediatric Blood & Cancer
T Asakura, A Higuchi, N Mori
No abstract text is available yet for this article.
July 2016: QJM: Monthly Journal of the Association of Physicians
Viviana Bacciedoni, Myriam Attie, Hugo Donato
The incidence of thrombosis is higher among newborn infants than in any other stage of pediatric development. This fact is the consequence of labile characteristics of the neonatal hemostatic system, in addition to exposure to multiple risk factors and the wide use of vascular catheters. Venous thromboses, which mainly affect the limbs, the right atrium and renal veins, are more frequently seen than arterial thromboses. A stroke may be caused by the occlusion of the arterial flow entering the brain or by occlusion of its venous drainage system...
April 2016: Archivos Argentinos de Pediatría
Divya Gupta, Laxmisha Chandrashekar, Bheemanathi Hanuman Srinivas, Devinder Mohan Thappa
No abstract text is available yet for this article.
March 2016: Indian Dermatology Online Journal
Marilyn J Manco-Johnson, Lisa Bomgaars, Joseph Palascak, Amy Shapiro, John Geil, Sandor Fritsch, Borislava G Pavlova, David Gelmont
Severe congenital protein C (PC) deficiency (SCPCD) is associated with disseminated intravascular coagulation (DIC), purpura fulminans (PF), and vascular thromboembolic events (TE), often leading to organ failure and death. PC replacement therapy offers a safe, effective treatment for thromboembolic complications of SCPCD and secondary prophylaxis for recurrent DIC, PF, and TEs. A prospective, multi-centre, open-label, phase 2/3 study was conducted to demonstrate the safety and efficacy of protein C concentrate for treatment of PF and acute TEs...
July 4, 2016: Thrombosis and Haemostasis
Natalia Rompoti, Uwe Hillen, Alexander Rösch, Joachim Dissemond
No abstract text is available yet for this article.
August 1, 2016: European Journal of Dermatology: EJD
Antonio Ali Perez-Maya, Rosa Maria Hinojosa-Robles, Jose Ramon Barcenas-Walls, Armando Vignau-Cantu, Hugo A Barrera-Saldaña, Rocio Ortiz-Lopez
We report here the draft genome sequence of aStreptococcus pneumoniaestrain isolated in Monterrey, Mexico, MTY1662SN214, from a man with purpura fulminans. The strain belongs to the invasive and multidrug-resistant serogroup 19A, sequence type 320 (ST320). The draft genome sequence consists of 60 large contigs, a total of 2,069,474 bp, and has a G+C content of 39.7%.
2016: Genome Announcements
Scott Pangonis, Pisespong Patamasucon, Ellen Fitzpatrick
Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF) are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD) with and without underlying immunological disorders such as asplenia...
January 2016: Journal of Investigative Medicine High Impact Case Reports
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