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一名成年流感嗜血杆菌败血症患者发生暴发性紫癜:病例报告及文献复习

Purpura fulminans in an adult patient with Haemophilus influenzae sepsis: case report and review of the literature.

作者信息

Gast Thomas, Kowal-Vern Areta, An Gary, Hanumadass Marella L

机构信息

Department of Trauma, Sumner L. Koch Burn Center, John H. Stroger, Jr., Hospital of Cook County, Chicago, Illinois 60612, USA.

出版信息

J Burn Care Res. 2006 Jan-Feb;27(1):102-7. doi: 10.1097/01.bcr.0000194269.95027.51.

Abstract

Purpura fulminans is a rare complication of a coagulopathy or an infection. Haemophilus influenzae infection, which has decreased since the haemophilus influenzae type B vaccine was initiated, is an unusual initiating cause of purpura fulminans. This case is the first reported in the literature of an adult who developed purpura fulminans after Haemophilus influenzae sepsis. Her elevated beta2 glycoprotein 1 ratio may have contributed to the severity of her disease. Although rare, Haemophilus influenzae may precipitate purpura fulminans. Current therapy is directed at control of precipitating factors, removal of nonviable tissue, treatment of secondary infections, and physiologic support. There also is evidence that patients respond well to hyperbaric oxygen therapy, with decreasing limb and tissue loss.

摘要

暴发性紫癜是凝血病或感染的一种罕见并发症。自乙型流感嗜血杆菌疫苗开始使用以来,流感嗜血杆菌感染有所减少,它是暴发性紫癜一种不常见的起始病因。该病例是文献中首次报道的一名成人在感染流感嗜血杆菌败血症后发生暴发性紫癜。她升高的β2糖蛋白1比值可能导致了疾病的严重程度。尽管罕见,但流感嗜血杆菌可能引发暴发性紫癜。目前的治疗针对控制诱发因素、清除坏死组织、治疗继发感染以及提供生理支持。也有证据表明患者对高压氧治疗反应良好,肢体和组织损失减少。

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