Malinosky Hannah R, Santiago Kristen
Internal Medicine, Texas Health Resources, Dallas, USA.
Cureus. 2025 Jul 9;17(7):e87617. doi: 10.7759/cureus.87617. eCollection 2025 Jul.
Purpura fulminans (PF) is a life-threatening thrombotic disorder characterized by rapidly progressive cutaneous hemorrhagic necrosis, disseminated intravascular coagulation (DIC), and multi-organ failure. Most commonly associated with meningococcemia, PF requires early recognition for optimal outcomes. This report presents the case of a 26-year-old immunocompetent but unvaccinated male who developed PF secondary to meningococcemia, complicated by refractory septic shock, multi-organ failure, and extensive tissue necrosis. His clinical course underscores the aggressive nature of this condition, the critical need for early recognition, and the importance of primary prevention through meningococcal vaccination. The patient's unvaccinated status highlights persistent gaps in vaccination uptake, particularly among individuals outside of university settings. Co-infection with COVID-19 and underlying alcohol use disorder may have contributed to immune dysregulation and increased disease severity. This case also raises awareness of the potential role of COVID-19 in the pathogenesis of meningococcemia. PF remains a dermatologic and hematologic emergency with high mortality, necessitating rapid diagnosis and a multidisciplinary treatment approach. Strengthening vaccination education and advocacy is essential to reduce the burden of PF and its complications.
暴发性紫癜（PF）是一种危及生命的血栓性疾病，其特征为迅速进展的皮肤出血性坏死、弥散性血管内凝血（DIC）和多器官功能衰竭。PF最常与脑膜炎球菌血症相关，需要早期识别以获得最佳治疗效果。本报告介绍了一例26岁免疫功能正常但未接种疫苗的男性病例，该患者因脑膜炎球菌血症继发PF，并发难治性感染性休克、多器官功能衰竭和广泛组织坏死。他的临床病程凸显了这种疾病的侵袭性、早期识别的迫切需求以及通过脑膜炎球菌疫苗接种进行一级预防的重要性。患者未接种疫苗的状态凸显了疫苗接种率持续存在的差距，尤其是在大学环境以外的人群中。新型冠状病毒肺炎（COVID-19）合并感染和潜在的酒精使用障碍可能导致了免疫失调并加重了疾病严重程度。该病例还提高了人们对COVID-19在脑膜炎球菌血症发病机制中潜在作用的认识。PF仍然是一种具有高死亡率的皮肤科和血液科急症，需要快速诊断和多学科治疗方法。加强疫苗接种教育和宣传对于减轻PF及其并发症的负担至关重要。
