Purpura Fulminans Associated with Streptococcus pneumoniae Septicemia in an Asplenic Pediatric Patient

Konda, Sailesh; Zell, Deborah; Milikowski, Clara; Alonso‐Llamazares, Javier

doi:10.1016/j.ad.2012.05.009

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…Disseminated intravascular coagulation (DIC) is a consumptive coagulopathy that can present secondary to infection with S. pneumoniae [33] or M. pneumoniae [34]. Like HUS, thrombocytopenia and anaemia are present but renal dysfunction is secondary to acute tubular necrosis rather than the thrombotic microangiopathy of the renal vasculature, that is seen in HUS [30].…”

Section: Disseminated Intravascular Coagulationmentioning

confidence: 99%

Complicated pneumonia in children

Pabary

Balfour‐Lynn

2013

BRE

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Section: Disseminated Intravascular Coagulationmentioning

confidence: 99%

Complicated pneumonia in children

Pabary

Balfour‐Lynn

2013

BRE

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“…2,3 Pneumococcal OPSI often progresses to multiple organ failure and disseminated intravascular coagulation (DIC), and occasionally purpura fulminans. 4,5 Fulminant pneumococcal infection similar to OPSI has been observed in healthy individuals. [6][7][8][9] Abdominal imaging or autopsy sometimes revealed a small spleen in such cases, and an association between "splenic hypoplasia" and severe pneumococcal infection has been discussed.…”

Section: Introductionmentioning

confidence: 96%

Splenic volume in severe sepsis is associated with disease severity and pneumococcal infection

Koga

Fujita

Nakahara

et al. 2016

Acute Medicine & Surgery

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Aim: A small spleen, which is occasionally found in patients with pneumococcal sepsis, may increase pneumococcal susceptibility because of splenic malfunction. However, a small spleen may also originate from severe disease. We carried out a retrospective study to evaluate the association between splenic volume and severe pneumococcal sepsis or disease severity. Methods:We reviewed the medical records of 23 patients with severe pneumococcal sepsis treated at our institution between January 2004 and September 2015 (pneumococcal group) and 61 patients with severe non-pneumococcal bacteremia treated between April 2011 and September 2015 (control group). Splenic volume measured by abdominal computed tomography on admission was compared between the two groups. Correlations between Acute Physiology and Chronic Health Evaluation (APACHE) II scores and splenic volume on admission and the change in splenic volume from the non-septic state to admission were also determined.Results: Splenic volume on admission was significantly smaller (P = 0.001) and a small spleen was more frequent (P < 0.001) in the pneumococcal group. The APACHE II score was negatively correlated with splenic volume on admission (r = À0.46, P < 0.001) and the change in splenic volume (r = À0.44, P = 0.004). Pneumococcal infection (odds ratio 13.1, 95% confidence interval 2.6-65.7; P = 0.002) and APACHE II score (odds ratio 1.2, 95% confidence interval 1.1-1.3; P = 0.002) were independently associated with small spleen.Conclusion: Splenic volume decreased with increasing severity of severe sepsis. A small spleen was also associated with severe pneumococcal infection.

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“…The attention is turned to skin loss management after acute phase, including debridement and grafting, such as escharotomies, fasciotomies, or major amputations. Early escharotomy is recommended in case of amputation [10]. In this case, the PF started by the time that the burn injury approximately healed, and the Staphylococcus epidermidis and Enterobacter cloacae , which were the pathogens of PF, were detected on the wound but not in the blood.…”

Section: Discussionmentioning

confidence: 99%

Purpura Fulminans following Thermal Injury

Jiang

et al. 2013

Case Reports in Emergency Medicine

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Purpura fulminans is a rare syndrome of intravascular thrombosis and hemorrhagic infarction of the skin, which is an unusual cutaneous manifestation of disseminated intravascular coagulation. It often occurs in small children and babies due to infection and/or sepsis, rarely in adults in clinic. We report the first case of deadly purpura fulminans following thermal injury in a 64-year-old Chinese woman. The purpura developed sharply and aggravated multiple organ dysfunction. The patient died of purpura fulminans, disseminated intravascular coagulation, and multiple organ dysfunction syndrome.

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Purpura Fulminans Associated with Streptococcus pneumoniae Septicemia in an Asplenic Pediatric Patient

Cited by 11 publications

References 12 publications

Complicated pneumonia in children

Complicated pneumonia in children

Splenic volume in severe sepsis is associated with disease severity and pneumococcal infection

Purpura Fulminans following Thermal Injury

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