Two adult cases of sepsis-associated purpura fulminans

DOI
  • YAMADA Kenji
    Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine
  • TARUI Takehiko
    Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine
  • MATSUDA Taketo
    Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine
  • MATSUDA Takeaki
    Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine
  • YAMAGUCHI Yosihiro
    Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine

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Two uncommon cases of sepsis-associated Purpura fulminans (PF) caused by urinary tract infection are herein reported. The first case involved an 81-year-old man, and the second an 80-year-old woman; both developed septicemia and disseminated intravascular coagulation (DIC). After admission to the intensive care unit (ICU), progressive purpuric skin necrosis became evident on the fingers and toes. Blood and urine cultures were positive for both Escherichia coli and Enterococcus faecalis in the first case and for Escherichia coli in the second. The patients were discharged from the ICU on day 17 and 36, respectively. All areas of necrosis subsequently separated from the underlying tissue. Because the mortality rate associated with PF is very high, priority must be given to general and symptomatic supportive therapy in patients with sepsis-associated PF.

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