Purpura fulminans (PF) is a descriptive term used to describe a heterogeneous group of disorders characterized by rapidly progressive purpuric lesions that may develop into extensive areas of skin necrosis, and peripheral gangrene. This rare disorder is associated with laboratory evidence of consumptive coagulopathy and is often fatal. PF is usually associated with many infections, most notably with meningococcal, staphylococcal, and streptococcal infections. However, there are very few reports of this entity with spotted fever and scrub typhus from India. Rickettsial infections are an underdiagnosed group of diseases presenting as acute febrile illness, with high mortality in untreated cases. Of the available tests, Weil–Felix is a handy and economical tool for early diagnosis of this fatal disease especially in resource poor settings. We present four infants with PF secondary to rickettsial fever diagnosed by the Weil–Felix test.

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sexual orientation and behavioural practices. This rising trend has been noted in United States of America, United Kingdom and India. Aims And Objectives: This study was done to observe the age, sex distribution, clinical presentation and serological ndings of syphilis in patients attending the OPD. Materials And Methods: A prospective detailed analysis of all the patients who had syphilis was done from May 2021 to July 2022. Age, occupation, marital status, sexual behavior and the complaints with which they present to OPD was collected. Information regarding the venereal disease research laboratory test (VDRL) and Treponema pallidum hemagglutination assay (TPHA) was noted. Results: Among the patients who attended the OPD between May 2021 to July 2022, 35 were found to have syphilis. Among them 17 had primary syphilis. Most of them belong the age group of 21-30 constituting 45.7%. Male constituted 71.4%. Most common occupation group affected in our study was farmer(28.5%). Homosexual behaviour was seen in 17.14% and heterosexual behaviour was seen 51.4%. The most common clinical feature seen in our study was papule which was seen in about 44% of males and among females it was maculopapular rash. With reference to anatomical site palms and soles were most commonly involved. Moth eaten alopecia was seen in 2 cases. HIV infection was noted in 8 people. Conclusion: Our study shows that the syphilis prevalence is more in males compared to women. Due to the change in sexual orientation and behavioural practices there is rise of syphilis in both homosexuals and heterosexuals. Farmers were the most common group affected and this shows the need for proper sexual education among the people living in the rural areas. The most common age group affected was the most sexually active group indicating the need for eliminating the stigma related to sexual education and counseling the young adults regarding the same

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