Article Text

Download PDFPDF
Rare disease
Atypical presentation of purpura fulminans following sepsis in an adult
  1. Paul Lyon1,
  2. Rabi Nambi2,
  3. Faisal Faruqi3
  1. 1Cardiology Department, Royal Derby NHS Trust, Derby, Derbyshire, UK
  2. 2Dermatology Department, Royal Derby NHS Trust, Derby, Derbyshire, UK
  3. 3Emergency Department, Queen’s Medical Centre Campus, Nottingham, Nottinghamshire, UK
  1. Correspondence to Faisal Faruqi, faizalfaruqi{at}aol.com

Summary

A 67-year-old morbidly obese female with a background of stage 4 chronic renal failure, ischaemic heart disease, congestive cardiac failure, atrial fibrillation and type 2 diabetes mellitus presented with sepsis and necrotic lesions of the proximal lower limbs. Initial histological findings were consistent with the clinical diagnosis of calciphylaxis and supportive treatment was commenced with addition of a phosphate binder and dietary restriction. Due to high anaesthetic risk, her wounds were managed with larva therapy in the first instance, however, ultimately surgical debridement was the required. Repeat histology from a further biopsy revealed necrosis secondary to numerous thrombi in the cutaneous vessels and a new diagnosis of purpura fulminans was made, likely secondary to her sepsis. Unfortunately, despite aggressive medical and surgical treatment measures, this patient died of multiple organ dysfunction following a prolonged admission.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.