Morales Hernandez Maria Del Mar, Carranza Michael, Patel Bijal, Calvert Joshua, Masri Ghania
Internal Medicine, University of Florida College of Medicine, Gainesville, USA.
Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Cureus. 2021 Feb 9;13(2):e13249. doi: 10.7759/cureus.13249.
Purpura fulminans (PF) is a rapidly fatal disorder predominantly encountered in patients with an acquired deficiency of physiologic anticoagulants due to severe sepsis and septic shock with disseminated intravascular coagulation (DIC). This consumptive process eventually leads to widespread thrombosis, hemorrhagic necrosis, and gangrene. Rapid identification followed by aggressive management of the underlying etiology with a multidisciplinary team is critical to prevent long-term organ dysfunction, disability from amputation, and death. While bleeding is a common finding in DIC, anticoagulation must be considered if PF is present. We report a case of -associated emphysematous pyelitis leading to bacteremia, septic shock, and PF with small- and medium-sized vessel thrombosis and acral ischemia.
暴发性紫癜（PF）是一种迅速致命的疾病，主要见于因严重脓毒症、脓毒性休克伴弥散性血管内凝血（DIC）导致生理性抗凝物质获得性缺乏的患者。这种消耗性过程最终会导致广泛血栓形成、出血性坏死和坏疽。迅速识别并由多学科团队积极处理潜在病因对于预防长期器官功能障碍、截肢导致的残疾和死亡至关重要。虽然出血是DIC的常见表现，但如果存在PF，则必须考虑抗凝治疗。我们报告一例与气肿性肾盂炎相关的病例，该病例导致菌血症、脓毒性休克和PF，并伴有中小血管血栓形成和肢端缺血。
