Sepsis-induced purpura fulminans caused byPasteurella multocida

Abstract

A 52-year-old man was admitted with a cutaneous rash associated with septic shock and multiorganic failure, 6 days after a dog bite. He was started on empiric antibiotherapy and supportive measures. The patient's condition aggravated, with need for invasive mechanical ventilation and intermittent haemodialysis, and evolution from a petechiae-like rash to purpura and gangrene, culminating in bilateral lower limb amputation. The blood cultures revealed onlyPasteurella multocida, after 10 days of incubation.P multocidainfection is a rare cause of soft tissue infection that subsides with oral antibiotherapy. Infections causing sepsis are rare and appear in immunocompromised patients.Purpura fulminansinduced by sepsis is a rare, life-threatening disorder. This syndrome should be recognised promptly, so early treatment is instituted. We found no case reports ofpurpura fulminanscaused byPasteurellainfections in our literature review.

Purpura fulminans and severe sepsis due toPasteurella multocidainfection in an immunocompetent patient

“…Thus, patients often require amputation of gangrenous extremities during the course of illness and suffer significant morbidity. It is crucial to realise that PF is not simply a dermatological emergency, but that it can also lead to multiorgan failure by affecting the lungs, kidneys and adrenal glands 5. In our case, PF developed 36 hours after the patient was admitted.…”

“…To the best of our knowledge, there is only one other case report of PF due to P. multocida infection 5. Other reported infectious causes for PF include Enterobacter cloacae , Staphylococcus aureus and Plasmodium falciparum malaria 7 8.…”

Microbiología de las infecciones causadas por mordeduras de perros y gatos en personas: Una revisión

“…En un total de 16 trabajos se describieron mordeduras en las manos 5,6,11,[13][14][15]17,21,22,25,27,31,[34][35][36]38 de las cuales cuatro de ellas habían sido producidas por gatos 13,21,36,38 , mientras que tres trabajos describieron mordeduras en los brazos 21,30,32 . Las mordeduras en la cara producidas en su totalidad por perros 24,26,29 mientras que las mordeduras descritas en extremidades inferiores fueron producidas en todos los casos por gatos 13,17,35,37 .…”

“…Entre las bacterias más frecuentemente aisladas, Staphylococcus spp se identifica en 50% de las mordeduras producidas por perros y gatos 4,9 . Pasteurella spp se aísla en 50% de los cultivos de mordeduras de perro y 75% de las ocasionadas por gato 7,9,12,15 . Por otra parte, Capnocytophaga canimorsus forma parte de la microbiota comensal de perros (entre 22 y 74% de los perros sanos) y gatos (en torno a 17% de los animales sanos) 16,17 .…”

Acute purpura fulminans—a rare cause of skin necrosis: A single‐institution clinicopathological experience

“…The infectious culprits in our series included 2 cases of Group A Streptococcus and 1 case each of S. pneumoniae , P. aeruginosa , K. pneumoniae , and vancomycin‐resistant Enterococcus ( faecium ). While Streptococci and Klebsiella species are commonly associated with AIPF, Pseudomonas and Enterococci are rarely implicated as causative bacterial agents 6,23,24 . Interestingly, no infectious organism could be isolated in 5 of our cases.…”