Mutreja Deepti, Moorchung Nikhil, Manasa S J, Varghese Jeenu
Department of Pathology, Command Hospital Air Force, Bengaluru, Karnataka, India.
Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India.
Indian J Pathol Microbiol. 2018 Apr-Jun;61(2):284-286. doi: 10.4103/IJPM.IJPM_209_17.
Acute meningococcemia is characterized by extensive purpurae consisting of both petechiae and ecchymoses. This condition can be rapidly fatal without treatment due to shock and severe consumptive coagulopathy. We report a case of fatal meningococcal septicemia in a military recruit who presented with fever and associated rapidly progressive purpuric rash (purpura fulminans) without any meningeal signs. Evaluation revealed evidence of disseminated intravascular coagulopathy and multiorgan failure. Diplococci were demonstrated in peripheral blood neutrophils and monocytes. On autopsy, extensive hemorrhages were found in both adrenals, lungs, liver, skin, and kidneys with secondary hemophagocytic lymphohistiocytosis in bone marrow. This report highlights useful information obtained from examination of peripheral blood smear in purpura fulminans.
急性脑膜炎球菌血症的特征是出现广泛的紫癜，包括瘀点和瘀斑。由于休克和严重的消耗性凝血病，如果不进行治疗，这种情况可能会迅速致命。我们报告一例军事新兵致命性脑膜炎球菌败血症病例，该患者表现为发热并伴有迅速进展的紫癜性皮疹（暴发性紫癜），无任何脑膜刺激征。评估显示存在弥散性血管内凝血和多器官功能衰竭。在外周血中性粒细胞和单核细胞中发现了双球菌。尸检发现双侧肾上腺、肺、肝、皮肤和肾脏均有广泛出血，骨髓中有继发性噬血细胞性淋巴组织细胞增生。本报告强调了从暴发性紫癜外周血涂片检查中获得的有用信息。
