Purpura fulminans in pneumococcal sepsis: Case report and review

被引:28
作者
Carpenter, CT [1 ]
Kaiser, AB [1 ]
机构
[1] VANDERBILT UNIV,SCH MED,DEPT MED,NASHVILLE,TN 37232
关键词
D O I
10.3109/00365549709011858
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Purpura fulminans is classically defined by ecchymotic skin lesions, fever, and hypotension. The majority of cases occur in association with bacterial sepsis, and disseminated intravascular coagulation (DIG) is usually present. Prompted by our experience with a patient with pneumococcal sepsis and purpura fulminans in whom hypotension was never observed, we evaluated the important parameters of sepsis in reports of this syndrome. 42 additional cases of pneumococcal bacteremia and purpura fulminans were identified. Hypotension was present in only 51%, Although DIC was present in 85% of patients, hypofibrinogenemia was documented in only 26%. By contrast, both hypotension and hypofibrinogenemia are present in the vast majority of patients described with purpura fulminans in association with meningococcal sepsis, These data confirm that hypotension is not a necessary feature of the syndrome of purpura fulminans associated with pneumococcal sepsis and suggest further that qualitative or quantitative differences exist in the DIC cascade of pneumococcal vs meningococcal sepsis.
引用
收藏
页码:479 / 483
页数:5
相关论文
共 41 条
[1]   PURPURA FULMINANS IN A CHILD WITH PNEUMOCOCCAL SEPTICEMIA 2 YEARS AFTER SPLENECTOMY [J].
ADNER, MM ;
KAUFF, RE ;
SHERMAN, JD .
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1970, 213 (10) :1681-&
[2]   UNUSUAL MANIFESTATIONS OF PNEUMOCOCCAL INFECTION IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTED INDIVIDUALS - THE PAST REVISITED [J].
BARRADAS, MCR ;
MUSHER, DM ;
HAMILL, RJ ;
DOWELL, M ;
BAGWELL, JT ;
SANDERS, CV .
CLINICAL INFECTIOUS DISEASES, 1992, 14 (01) :192-199
[3]  
BENSON PM, 1988, ARCH DERMATOL, V124, P1851
[4]   SYMMETRIC PERIPHERAL GANGRENE IN PNEUMOCOCCAL SEPSIS [J].
BETTIGOLE, R .
ANNALS OF INTERNAL MEDICINE, 1961, 54 (02) :335-+
[5]  
BIELORY L, 1991, ANN ALLERGY, V66, P459
[6]   GRAM-POSITIVE ORGANISMS AND SEPSIS [J].
BONE, RC .
ARCHIVES OF INTERNAL MEDICINE, 1994, 154 (01) :26-34
[7]   THE ROLE OF THE SPLEEN IN EXPERIMENTAL PNEUMOCOCCAL BACTEREMIA [J].
BROWN, EJ ;
HOSEA, SW ;
FRANK, MM .
JOURNAL OF CLINICAL INVESTIGATION, 1981, 67 (04) :975-982
[8]   MECHANISMS OF HOST DEFENSE AGAINST INFECTION WITH STREPTOCOCCUS-PNEUMONIAE [J].
BRUYN, GAW ;
ZEGERS, BJM ;
VANFURTH, R .
CLINICAL INFECTIOUS DISEASES, 1992, 14 (01) :251-262
[9]  
*CDCP, 1995, MMWR-MORBID MORTAL W, V43, P99
[10]  
Cohen J R, 1990, Ann Vasc Surg, V4, P276, DOI 10.1007/BF02009457