Abdul Kalam Sumayya, Carey Ronald Ab, Antony John, Abraham O C
Postgraduate Registrar, Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Professor, Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Trop Doct. 2020 Oct;50(4):330-334. doi: 10.1177/0049475520930622. Epub 2020 Jun 17.
Acute infectious purpura fulminans is a serious, potentially fatal condition. We present a case series of 11 patients from March 2005 to March 2017, whose clinical symptoms were fever (100%), confusion (63.6%) and headache (55%), and whose common laboratory abnormalities were thrombocytopenia (100%), elevated alkaline phosphatase (70%) and anaemia (63.6%). Three patients (27%) developed gangrene and two presented in shock. Only one grew Neisseria meningitidis in cerebrospinal fluid (CSF) culture and another confirmed by latex agglutination and polymerase chain reaction in CSF. Five others had serology confirmed spotted fever rickettsioses (SFG). All received broad spectrum antibiotics; in 9/11 patients, this included doxycycline or azithromycin. The mean hospital stay was 10.2 days and overall mortality was 18.2%.
