Acute infectious purpura fulminans due to probable spotted fever

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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“…Antibiotic susceptibility does not vary much among the different species and hence exact species identification is not essential. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

Purpura fulminans secondary to rickettsial infections: A case series

Katoch¹,

Kallappa²,

Shamanur³

et al. 2016

Indian Dermatol Online J

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“…R. conorii subsp. indica was reported in several case series from the Indian subcontinent as a cause of fern-leaf pattern purpura, although the specific rickettsial subtype was infrequently identified in these studies ( 15 – 20 ).…”

Section: Discussionmentioning

confidence: 95%

Two Cases of Israeli Spotted Fever with Purpura Fulminans, Sharon District, Israel

Cohen¹,

Babushkin²,

Shapiro³

et al. 2018

Emerg. Infect. Dis.

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“…Katoch et al described a case series of purpura fulminans that included four pediatric patients treated with doxycycline with good recovery [ 16 ]. The few similar cases successfully treated with doxycycline have been reported mainly from the Indian subcontinent [ 17 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

Rare presentation of rickettsial infection as purpura fulminans: a case report

Dalugama¹,

Gawarammana²

2018

J Med Case Reports

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BackgroundPurpura fulminans is an acute life-threatening disorder characterized by intravascular thrombosis and hemorrhagic infarction of the skin complicated with disseminated intravascular coagulation. It is commonly seen in acute infections following meningococcal and streptococcal infections. Few cases of purpura fulminans following rickettsial infections have been described in the literature.Case presentationWe report a case of a 55-year-old Sri Lankan woman who presented to Teaching Hospital Peradeniya with a febrile illness, headache, and myalgia that progressed to an erythematous rash starting over the bilateral lover limbs and hands and that became black and necrotic with a few hemorrhagic blebs. She had normocytic anemia, platelet clumps, and monocytosis as well as a deranged clotting profile. The result of immunofluorescence antibody testing for rickettsial immunoglobulin G was strongly positive for Rickettsia conorii with a rise in titer convalescent sera, and a diagnosis of purpura fulminans following rickettsial infection was made. The patient made an excellent recovery with chloramphenicol treatment.ConclusionsThe treating physician should consider the rare but very treatable condition of rickettsial infection as a differential diagnosis in the etiological diagnostic workup of patients presenting with severe purpuric and hemorrhagic rash with fever.

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Acute infectious purpura fulminans due to probable spotted fever

Cited by 11 publications

References 5 publications

Purpura fulminans secondary to rickettsial infections: A case series

Purpura fulminans secondary to rickettsial infections: A case series

Two Cases of Israeli Spotted Fever with Purpura Fulminans, Sharon District, Israel

Rare presentation of rickettsial infection as purpura fulminans: a case report

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