Idiopathic purpura fulminans in dengue hemorrhagic fever

Abstract

Purpura fulminans is a rapidly progressive thrombotic disease that has been described during both severe bacterial and viral infections. Disseminated intravascular coagulation (DIC), antiphospholipid antibodies and acquired or congenital C and S protein deficiency are thought to play a role in its pathogenesis. Here we report the case of a 4-yearold girl who developed gangrene of all her fingers and toes following dengue shock syndrome complicated by DIC and also discuss its management.

Symmetrical peripheral gangrene

“…[3] Rather, purpura fulminans is characterized by acute onset, rapidly progressive purpuric lesions leading to skin necrosis, gangrenous changes of limbs or digits and organ dysfunction. [4] Hutchison first described SPG in 1891. [5] Although described more than a century ago, most of the cases of SPG have been documented as single case reports.…”

Severe Thrombotic Events Associated with Dengue Fever, Brazil

“…9 Antibodies against phospholipids and increased lupus anticoagulant have been anecdotally associated with thrombotic events in peripheral arteries and cerebral vasculature in dengue fever patients. 10,11 Venous cerebral vasculature thrombosis and ischemic stroke not associated with antibodies against phospholipids or other risk factors have been rarely reported in dengue fever patients. in thrombotic events in dengue fever should be considered.…”

“…1 To our knowledge, deep vein thrombosis, pulmonary thromboembolism, and mesenteric vein thrombosis have not been reported in direct association with dengue fever. 1,11,12 Mesenteric vein thrombosis was an unusual complication of DENV infection, and was erroneously diagnosed in an imaging study of suspected cholangitis in a patient with clinical sepsis without a primary source. Awareness for these kinds of complications should be recommended to all practitioners who treat patients with dengue fever, particularly in hospital settings.…”

Symmetrical peripheral gangrene: A rare complication of dengue fever

“…[4] Severe complications of dengue infections such as liver failure, disseminated intravascular coagulation, encephalopathy, myocarditis, acute renal failure, and hemolytic uremic syndrome are rare but have been frequently noted in recent epidemics. [5] Though idiopathic purpura fulminans as a rare complication of dengue hemorrhagic fever was reported earlier, [6] to our knowledge, SPG associated with dengue infection has not yet been reported anywhere.…”