Purpura Fulminans in an adult with Pseudomonas aeruginosa septicemia

Abstract

Purpura fulminans is a serious dermatological condition that can be a sequela of sepsis complicated by disseminated intravascular coagulopathy (DIC). This occurs most frequently in children with Neisseria meningitis or Streptococcus pneumoniae infection. Once diagnosed, treatment of the underlying infection, surgical debridement, and replacement of anticoagulation factors are recommended. Most patients suffer significant long-term morbidity, including amputations and sometimes death. We describe a rare case of an adult patient with Pseudomonal bacteremia leading to purpura fulminans. The patient's underlying infection was promptly treated and her lesions were debrided appropriately. However, correction of coagulopathy was not pursued. Despite this, amputations were avoided and the patient survived. This case demonstrates the need to be vigilant and open minded to the diagnosis of dermatological diseases with atypical presentations. Further, it highlights the chief importance of treating the underlying infection and providing proper wound care in septic purpura fulminans.