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Sepsis fulminans

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
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
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)
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
Neha Rathor, Vikas Khillan, S K Sarin
Strongyloidiosis is usually an asymptomatic chronic nematodal disease. The term hyperinfection is used to denote autoinfection, a phenomenon in which the number of worms increases enormously. Development or exacerbation of gastrointestinal and pulmonary symptoms is seen, (A) and the detection of increased numbers of larvae in stool and or sputum is the hallmark. It is known to occur with a change in immune status of the host; this can occur due to immunosuppressants. Cytomegalovirus (CMV) is also known to suppress host immunity...
January 2016: Indian Journal of Critical Care Medicine
Brigitte Meyer, Christoph Wenisch, Doris Haider, Stephanie Neuhold, Paul Knoebl
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Yariv Fruchtman, Tzipora Strauss, Marina Rubinstein, Miriam Ben Harush, Shoshana Revel-Vilk, Joseph Kapelushmik, Gideon Paret, Gili Kenet
Purpura fulminans (PF) is a very rare clinicopathologic skin disorder comprising dermal microvascular thrombosis associated with perivascular hemorrhage of multiple origins. It may occur as the presenting symptom of severe congenital deficiency of protein C (PC) or protein S (PS) during the newborn period, or later in life following oral anticoagulant therapy with vitamin K antagonists, or of sepsis that may be associated with disseminated intravascular coagulation. Treatment consists of anticoagulants and PC concentrates during acute episodes...
2015: Pediatric Hematology and Oncology
F Hmami, H Cherrabi, A Oulmaati, Y Bouabdallah, A Bouharrou
Severe congenital protein C deficiency is a rare life-threatening coagulopathy. In the early hours of life, the neonate presents with extensive purpura fulminans and substantial skin necrosis contrasting with a preserved general state and a negative infectious exam. Disseminated intravascular coagulation sets in secondarily. Prenatal outset of thrombotic events is a rare situation that worsens the prognosis, especially protein C replacement in utero is not available. We report a case of a male newborn of consanguineous parents who were asymptomatic carriers of heterozygous protein C deficiency...
October 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Anis Miladi, Brian C Thomas, Knox Beasley, Jon Meyerle
Purpura fulminans is a nonspecific hematologic emergency with high initial mortality, representing a thrombotic occlusion of blood vessels leading to skin necrosis and disseminated intravascular coagulation, and often reported in the setting of sepsis. We report a case of nonfatal purpura fulminans in the context of angioimmunoblastic T-cell lymphoma (AITL).
February 2015: Cutis; Cutaneous Medicine for the Practitioner
C Tomasini
Sepsis is a potentially life-threatening complication of an infection where cutaneous lesions often represent one of the early signs. A myriad of microorganisms including bacteria, fungi, yeasts, viruses, protozoas, helminths and algae can be implicated. A broad spectrum of clinical and histopathologic findings can be observed in the skin and the common denominator is a thrombotic vasculopathy. The pathogenesis of cutaneous septic vasculitis (SV)/vasculopathy is complex and includes five main mechanisms: disseminated intravascular coagulation, direct invasion and occlusion of blood vessel walls by microorganisms, hypersensitivity reaction with immune complex deposition into blood vessel walls, embolism from a distant infectious site and vascular effects of toxins...
February 2015: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Akira Endo, Atsushi Shiraishi, Junichi Aiboshi, Yoshiro Hayashi, Yasuhiro Otomo
Here, we report a case of a 41-year-old male diagnosed as septic shock with purpura fulminans (PF) infection. The causative organism was β-lactamase-negative ampicillin-resistant Hemophilus influenzae. He developed fulminant cardiac dysfunction approximately 1 h after admission, and the cause was considered to be septic cardiomyopathy. Blood pressure and oxygenation were maintained at adequate levels with the aid of extracorporeal membrane oxygenation (ECMO). The cardiac dysfunction was reversible, and he was successfully weaned from ECMO on day 12 of hospitalization...
2014: Journal of Intensive Care
Megumi Tanosaki, Naomi Shimizu, Christine G Lian, Martha Jurchak, Vihas Patel
BACKGROUND: Purpura fulminans (PF) is a rare but lethal complication of severe infection. Aggressive surgical debridement of irreversibly devitalized tissue improves survival frequently at the cost of disfigurement. The ethical dilemma of surrogate decision-making for these often incapacitated patients presents a unique challenge for acute care surgeons managing necrotizing soft tissue infections (NSTI). METHODS: Case presentation and scholarly discussion of substituted judgment...
December 2014: Surgical Infections
Avanikkha Elayappen, Sunil K Jain, Michael J Loeffelholz, Janak Patel
INTRODUCTION:  Purpura fulminans (PF) is a skin manifestation due to hemorrhagic infarction caused by intravascular thrombosis secondary to bacterial infections or deficiency of anticoagulants such as protein C and protein S. Neonatal PF is a rare but potentially disabling disorder associated with a high mortality and severe long term morbidity in those who survive. CASE DESCRIPTION:  We report a case of a premature infant who developed extensive PF due to late onset group B streptococcus sepsis...
November 2014: American Journal of Perinatology Reports
Dhiraj Jain, Stalin Viswanathan, Chandramohan Ramasamy
We describe a 74-year-old man with purpura fulminans and altered sensorium following an acute febrile illness. Intensive sepsis management was to no avail, until institution of doxycycline therapy following confirmation of scrub typhus. Empirical doxycycline needs to be considered in endemic areas for patients presenting with purpura fulminans.
2014: Case Reports in Dermatological Medicine
F M Brunkhorst, V Patchev
BACKGROUND: Purpura fulminans is a rare life-threatening condition which is characterized by disseminated thrombosis in dermal and systemic microcirculation, cutaneous hemorrhages with progressing necrosis and multiple organ failure. The underlying pathogenesis is based on the disruption of the intrinsic anticoagulation cascade, with protein C deficiency being considered the leading factor in this process. In the majority of cases, the condition emerges as consumptive coagulopathy associated with severe sepsis...
November 2014: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Naomi Mathew, Christopher Henry, Manaf Zaizafoun, Shekhar Ghamande
SESSION TITLE: Critical Care Case Report Posters IIISESSION TYPE: Affiliate Case Report PosterPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Janus kinase inhibitors are increasingly being used for rheumatoid arthritis. We highlight a case of immune modulation induced by tofacitinib resulting in severe sepsis and purpura fulminans.CASE PRESENTATION: A 64 year old Caucasian lady with rheumatoid arthritis was admitted with septic shock and suprapubic tenderness after a 1 day prodrome of fever and malaise...
October 1, 2014: Chest
Anjan Kumar Dhua, Manoj Joshi, Nishad Plakkal, Lalitha Krishnan
BACKGROUND: Purpura fulminans and bilateral perinatal testicular torsion are rare and may co-exist. CASE CHARACTERISTICS: A 3-day-old neonate with bilateral swelling of scrotum; torsion and gangrenous changes were observed on exploration. INTERVENTIONS: Left orchidectomy with preservation of right testis was done. OUTCOME: At 2-month follow-up, right testis showed signs of atrophy. Child developed full thickness skin lesions and died of sepsis...
September 2014: Indian Pediatrics
Suhasini Tirumala, Bijayini Behera, Srikanth Jawalkar, Pradeep Kumar Mishra, Pavithra Vani Patalay, Sudha Ayyagari, Pavani Nimmala
Seriously ill patients presenting with purpura fulminans, sepsis and multi-organ failure often require extensive diagnostic workup for proper diagnosis and management. Host of common infections prevalent in the tropics, e.g. malaria, dengue; other septicemic infections e.g. meningococcemia, typhoid, leptospirosis, toxic shock syndrome, scarlet fever, viral exanthems like measles, infectious mononucleosis, collagen vascular diseases (Kawasaki disease, other vasculitis) diseases, and adverse drug reactions are often kept in mind, and the index of suspicion for rickettsial illness is quite low...
July 2014: Indian Journal of Critical Care Medicine
Ting He, Jiong-yu Hu, Jian Han, Dong-xia Zhang, Xu-pin Jiang, Bing Chen, Yue-sheng Huang
Purpura fulminans (PF) is a life-threatening hemorrhagic condition. Because of the rarity and randomness of the disease, no improvement in treatment has been made for a long time. In this study, we assessed the serum proteome response to PF by comparing serum proteins between healthy controls and PF patient. Liquid chromatography with tandem mass spectrometry (LC-MS/MS) approach was used after depleting 6 abundant proteins of serum. In total, 262 proteins were confidently identified with 2 unique peptides, and 38 proteins were identified significantly up- (≥ 2) or downregulated (≤ 0...
2014: Disease Markers
Jeffrey S Cooper, Peter Allinson, Lon Keim, Joe Sisson, Dan Schuller, Joe Sippel, David H Kovaleski
INTRODUCTION: We report a case of a previously healthy adult with flulike symptoms who precipitously declined due to pneumococcal sepsis complicated by disseminated intravascular coagulation (DIC) and purpura fulminans (PF). After one week of care, including ventilation support and hemodialysis, the patient was stable enough for hyperbaric oxygen (HBO2) in an attempt to salvage his threatened extremities. HBO2 resulted in reduction of ischemic tissue and demarcation of blackened tissue to the distal digits...
January 2014: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
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