Sheridan R L, Briggs S E, Remensnyder J P, Tompkins R G
Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Burns. 1996 Feb;22(1):53-6. doi: 10.1016/0305-4179(95)00078-x.
Purpura fulminans (PF), which describes the necrosis of soft tissue secondary to diffuse microvascular thrombosis induced by transient protein C deficiency associated with meningococcal sepsis, is unusual despite the approximately 15000 cases of bacterial meningitis which occur annually in the USA. PF has a reported mortality of 50 per cent secondary to multiple organ failure which commonly accompanies the syndrome and is associated with major long-term morbidity in those who survive. Children who develop multiple organ failure in association with purpura fulminans are difficult management problems and benefit from the unique surgical and critical care resources available in burn centres. We describe our recent experience with three such patients and suggest a management strategy, the key components of which include early excision and closure of deep wounds, aggressive critical care management and long-term follow-up should delayed epiphyseal growth occur.
暴发性紫癜（PF）是指与脑膜炎球菌败血症相关的短暂蛋白C缺乏引起弥漫性微血管血栓形成继发的软组织坏死，尽管美国每年约有15000例细菌性脑膜炎病例，但PF仍不常见。据报道，PF因多器官功能衰竭导致的死亡率为50%，多器官功能衰竭通常伴随该综合征出现，并且在幸存者中会导致严重的长期发病率。并发暴发性紫癜和多器官功能衰竭的儿童治疗起来很棘手，而烧伤中心具备的独特外科和重症监护资源对他们有益。我们描述了最近对3例此类患者的治疗经验，并提出了一种管理策略，其关键组成部分包括早期切除并闭合深部伤口、积极的重症监护管理，以及如果出现骨骺生长延迟则进行长期随访。
