scholarly journals Development of Bilateral Heterotopic Ossification After Survival of Life Threatening Purpura Fulminans

Cureus ◽  
2020 ◽  
Author(s):  
Mohammed Asif ◽  
Kevin M Klifto ◽  
Tomer Lagziel ◽  
Julie Caffrey
Keyword(s):  
Heterotopic Ossification ◽  
Purpura Fulminans ◽  
Life Threatening

Streptococcal Toxic Shock Syndrome Revealed by a Peritonitis

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Vuilleumier ◽  
Halkic
Keyword(s):  
Toxic Shock Syndrome ◽  
Group A Streptococcus ◽  
Early Recognition ◽  
Post Partum ◽  
Fatal Outcome ◽  
Purpura Fulminans ◽  
Infectious Complications ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Life Threatening

Group A streptococcus (GAS) or Streptococcus pyogenes cause a variety of life-threatening infectious complications including necrotizing fasciitis, purpura fulminans and streptococcal toxic shock syndrome (STSS). Exotoxins that act as superantigens are felt to be responsible for STSS. These exotoxins are highly destructive to skin, muscle and soft tissue. This syndrome has a rapid and fulminant course with frequently fatal outcome. GAS remains sensitive to penicillin but in serious infection a combination of clindamycin and ceftriaxone or meropenemum is recommended. Several studies have shown that mortality was dramatically reduced in STSS patients treated with immunoglobulin G given intravenously (IVIG). Early recognition of this most rapidly progressive infection and prompt operative debridement are required for successful management. This report presents a female patient at two month post-partum with a peritonitis and multi-organ failure.

scholarly journals Identification of Differentially Expressed Serum Proteins in Infectious Purpura Fulminans

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ting He ◽  
Jiong-yu Hu ◽  
Jian Han ◽  
Dong-xia Zhang ◽  
Xu-pin Jiang ◽  
...  
Keyword(s):  
Serum Proteins ◽  
Purpura Fulminans ◽  
Differentially Expressed ◽  
Healthy Controls ◽  
Differentially Expressed Proteins ◽  
Novel Proteins ◽  
Proteomic Study ◽  
Long Time ◽  
Life Threatening ◽  
Alpha 1 Antitrypsin

Purpura fulminans (PF) is a life-threatening hemorrhagic condition. Because of the rarity and randomness of the disease, no improvement in treatment has been made for a long time. In this study, we assessed the serum proteome response to PF by comparing serum proteins between healthy controls and PF patient. Liquid chromatography with tandem mass spectrometry (LC-MS/MS) approach was used after depleting 6 abundant proteins of serum. In total, 262 proteins were confidently identified with 2 unique peptides, and 38 proteins were identified significantly up- (≥2) or downregulated (≤0.5) based on spectral counting ratios (SpCPF/N). In the 38 proteins with significant abundance changes, 11 proteins were previously known to be associated with burn or sepsis response, but 27 potentially novel proteins may be specifically associated with PF process. Two differentially expressed proteins, alpha-1-antitrypsin (SERPINA1) and alpha-2 antiplasmin (SERPINF2), were validated by Western blot. This is the first study where PF patient and healthy controls are compared in a proteomic study to elucidate proteins involved in the response to PF. This study provides an initial basis for future studies of PF, and the differentially expressed proteins might provide new therapeutic targets to decrease the mortality of PF.

scholarly journals Neonatal Purpura Fulminans

2014 ◽  
Vol 34 (1) ◽  
pp. 80
Author(s):  
D Sharma ◽  
J Yadav
Keyword(s):  
Purpura Fulminans ◽  
Severe Infection ◽  
High Morbidity ◽  
S Deficiency ◽  
Rapid Spread ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Gram Negative Organisms

Neonatal purpura fulminans is a rare, life-threatening condition of dermal microvascular thrombosis associated with DIC and perivascular hemorrhage in the newborn period associated with high morbidity and mortality [1]. Gram negative organisms and Staphylococcus species are the most common causes of the acute infectious type [2]. It may be congenital, as a result of protein C and S deficiency, or acquired due to severe infection. It is characterized by the rapid spread of symmetrical, bluish-black hemorrhages into the skin, affecting mainly the extensor surfaces of the extremities and showing a tendency to deep necrosis and the formation of sero-sanguineous bullae. The haemorrhagic areas are well defined and are surrounded by oedema. These lesions are accompanied by a high fever and intense systemic symptoms.DOI: http://dx.doi.org/10.3126/jnps.v34i1.8975 J Nepal Paediatr Soc 2014;34(1):80

Genetic Determinants of Sepsis Outcomes

2014 ◽  
Author(s):  
Sachin Yende ◽  
Derek C Angus
Keyword(s):  
Critical Illness ◽  
Heterotopic Ossification ◽  
Hormonal Changes ◽  
Current Standard ◽  
Joint Contractures ◽  
Inflammatory Status ◽  
Significant Impairment ◽  
Life Threatening ◽  
Laboratory Biomarkers ◽  
High Index Of Suspicion

Bone and joint processes take second stage to life-threatening organ failure in the setting of critical illness. However, bone and joint disorders can cause significant impairment in survivors of critical illness. Return to pre-admission function is often limited by acquired complications such as joint contractures, heterotopic ossification, and altered bone metabolism. Critical care physicians should maintain a high index of suspicion for joint contractures, as they are often asymptomatic but the source of enduring disability once the critical illness had receded. Research is needed to document the effectiveness of alternate positioning, stretching, and bracing which are the current standard practice for prevention of contractures. Heterotopic ossification should be considered in the context of a swollen, warm, painful musculoskeletal site. Early detection with triple phase bone scan and, in some cases, prophylaxis with non-steroidal anti-inflammatory medication or radiation may be warranted. Bone hyperresorption in ICU patients can be caused by immobility, heightened inflammatory status, medication, hormonal changes, and vitamin D deficiency. Laboratory biomarkers can guide treatment, which is important to prevent long-term osteoporosis and stress fractures. Systematic physical examination and early patient mobilization may represent important steps to detect and prevent joint contractures and heterotopic ossification.

scholarly journals A Life Threatening Rash, an Unexpected Cause

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Dhiraj Jain ◽  
Stalin Viswanathan ◽  
Chandramohan Ramasamy
Keyword(s):  
Scrub Typhus ◽  
Purpura Fulminans ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Sepsis Management ◽  
Altered Sensorium ◽  
Life Threatening ◽  
Endemic Areas

We describe a 74-year-old man with purpura fulminans and altered sensorium following an acute febrile illness. Intensive sepsis management was to no avail, until institution of doxycycline therapy following confirmation of scrub typhus. Empirical doxycycline needs to be considered in endemic areas for patients presenting with purpura fulminans.

Dermatologic Emergencies in the Intensive Care Unit

2019 ◽  
pp. 391-394
Author(s):  
Matthew R. Hall
Keyword(s):  
Drug Hypersensitivity ◽  
Purpura Fulminans ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Eruptions ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Skin Conditions ◽  
Prompt Diagnosis ◽  
Drug Hypersensitivity Syndrome

Rashes are relatively common in hospitalized patients, but only rarely are they life threatening. Emergent skin conditions in these patients are usually sequelae of medication reactions (drug eruptions) or complications from sepsis. Most drug eruptions are benign and resolve if the offending medication is discontinued. However, the drug hypersensitivity syndrome, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) are urgent conditions that require prompt diagnosis and management. Purpura fulminans can develop in patients with sepsis and disseminated intravascular coagulation.

scholarly journals Acute Infectious Purpura fulminans in A 2-Year Old Child

2020 ◽  
Vol 1 (1) ◽  
pp. 104-109
Author(s):  
PO Osho ◽  
TM Adaja ◽  
O Odunlade ◽  
O Ige ◽  
MAO Ojo ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Financial Constraints ◽  
Viral Infections ◽  
Purpura Fulminans ◽  
Clinical Syndrome ◽  
Gram Positive ◽  
Cutaneous Manifestations ◽  
Haemorrhagic Infarction ◽  
Life Threatening ◽  
Gram Negative Organisms

Purpura fulminans (PF) is a rapidly progressing clinical syndrome of haematologic and cutaneous manifestations accompanied by an underlying dysfunction of coagulation resulting in disseminated intravascular coagulation (DIC). It is a life threatening haematologic emergency characterized by extensive skin necrosis with haemorrhagic infarction, hypotension and gangrene which may arise from severe sepsis, mostly gram negative organisms. Some gram positive organisms and viral infections have been implicated in the aetiology of PF. We reported a case of purpura fulminans in a 2 year old boy with severe sepsis and peripheral gangrene from gram positive coccus (Staphylococcus aureus). Even though we were faced with limitations in terms of laboratory support and parental financial constraints in the management of the patient; he survived mainly on supportive care and antibiotics.

scholarly journals Protein C Deficiency

2019 ◽  
Vol 143 (10) ◽  
pp. 1281-1285 ◽  
Author(s):  
Peyman Dinarvand ◽  
Karen A Moser
Keyword(s):  
Protein C ◽  
Treatment Options ◽  
False Negative ◽  
Purpura Fulminans ◽  
Protein C Deficiency ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Elevated Activity ◽  
Proc Gene ◽  
Low Activity

Protein C (PC) deficiency is a heritable or acquired risk factor for thrombophilia, with presentations varying from asymptomatic to venous thromboembolism to neonatal purpura fulminans, a life-threatening disorder. Hereditary PC deficiency is caused by mutation in the PC (PROC) gene located on chromosome 2q14.3. Heterozygous and acquired PC deficiencies are more common than homozygous deficiency. The recommended initial laboratory test measures PC activity using either clot-based or chromogenic methods. There are numerous potential interferences in PC activity testing that may result in either false-positive (falsely low activity) or false-negative (falsely normal or elevated activity) results. In the present review, we discuss common clinical presentations; laboratory testing, with a focus on potential assay interferences; treatment options; and prognosis in patients with PC deficiency.

scholarly journals A rare case of varicella gangrenosum in adult

2020 ◽  
Vol 7 (2) ◽  
pp. 599
Author(s):  
M. Sabari Girieasen ◽  
Naveenkumar Viswanathan ◽  
M/ S. Kalyankumar
Keyword(s):  
Soft Tissues ◽  
Rare Complication ◽  
Purpura Fulminans ◽  
The Body ◽  
Surgical Debridement ◽  
Chicken Pox ◽  
Serous Discharge ◽  
Threatening Condition ◽  
Life Threatening ◽  
Split Skin

Varicella gangrenosum is a gangrenous ulceration of varicella lesions involving the skin and soft tissues of the body. It most commonly occurs in children less than 5 years of age and life threatening. This is a very rare complication of chicken pox in adults which deserves early diagnosis and management. 21-year-old male presented with blackish discoloration in the lateral aspect of right thigh for 5 days. He has positive history of chicken pox for his brother and sister following which he acquired it 15 days back. During that episode he had fever, headache and blisters which ruptured to heal by scab. But scab in right thigh coalesced to form the gangrenous area with serous discharge. On presentation he had no fever with local lesion and surrounding erythema. Patient underwent radical surgical debridement and regular dressing. Pus culture was sent which showed no growth. He gradually improved and the ulcer granulated well and split skin graft is done. Varicella gangrenosum is a life-threatening condition which can be either wet, moist or purpura fulminans. Patients who develop disseminated intravascular coagulation and have a grave prognosis. Surgical debridement is the only proven treatment which has led to better outcome. Only about 10 cases reported in literature so far regarding this condition. 

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