Brazilian purpuric fever
H aegyptius usually causes a self-limiting purulent conjunctivitis in hot climate areas. BPF symptoms begin 1-2 weeks after an episode of purulent conjunctivitis, with high fever, abdominal pain, and purpura resembling fulminant meningococcemia. The illness can quickly progress to septic shock and death. Without treatment, mortality rate is about 70% and most patients die within 24 hours. However, if treated with antibiotics before the development of later symptoms, patients have an improved chance of survival.
BPF was first recognized in 1984, and no major outbreaks have been reported since 1990; sporadic cases were reported in 2007 with 7 cases without confirmation of H aegyptius.
A48.4 – Brazilian purpuric fever
8554002 – Brazilian purpuric fever
Differential Diagnosis & Pitfalls
- Viral or bacterial conjunctivitis
- Acute meningococcemia
- Viral hemorrhagic fever
- Dengue fever
- Bacterial meningitis
- Disseminated intravascular coagulation
- Idiopathic thrombocytopenic purpura
- Thrombotic thrombocytopenic purpura / hemolytic uremic syndrome
- Kaposi sarcoma / vascular tumor