Fulminating purpura with gangrene of lower extremity necessitating amputation

Purpura Fulminans in a Newborn Baby

“…A number of reports have appeared under the various headings of purpura fulminans (Little, 1959;Crawford and Riddler, 1959;Heal and Kent, 1953;Chambers, Holyoke and Wilson, 1952), fulminating purpura (Turin, Mandel and Hornstein, 1959), purpura necrotica (Sheldon, 1947), purpura haemorrhagica (Hunt, 1938), gangrenous purpura (Dunn, 1951) and purpura gangrenosa (Taylor and Wright, 1956) in which the authors describe a very similar picture to the case under review. A well-defined clinical syndrome exists which has been referred to by the above titles.…”

“…The syndromes of purpura fulminans, thrombotic thrombocytopenic purpura (thrombotic microangiopathic haemolytic anaemia or Moschcowitz's syndrome), periarteritis nodosa and anaphylactoid purpura (Henoch-Schonlein purpura) all have an obscure aetiology and pathogenesis. Many authors (Crawford and Riddler, 1959;Heal and Kent, 1953;Chambers et al, 1952;Turin et al, 1959;Seinfeld et al, 1960;Balf, 1951;Kingsley and Aquino, 1958;Craig and Gitlin, 1957;Wile and Sturgeon, 1956;Gairdner, 1948;Robinson, Orchard and Eden, 1958;Vernier, Worthen, Peterson, Colle and Good, 1961) feel that the primary fault appears to be a focal vascular lesion with swelling of the endothelium, rupture of the vessel wall and haemorrhage. These authorities have suggested independently that each disease is primarily a vascular disorder caused by an abnormal immunological mechanism of unknown origin.…”