Purpura fulminans in Adult
In adults, purpura fulminans usually occurs in the setting of acute infection. Neisseria and varicella are the 2 most common causes, but pneumococci, measles, staphylococci, and Group A or B beta-hemolytic streptococci are also causes. Acute illness, eg, septic shock, presents with high fever and rapid deterioration, leading to hypotension and end-organ dysfunction. There is often progression from initial acral purpura to widespread ecchymoses and gangrene.
Asplenia is also a risk factor for acute purpura fulminans.
Purpura fulminans can also occur in a postinfectious form 7-10 days following a bacterial or viral illness and is thought to be due to temporary decreases in proteins C and S or antithrombin III (such as from antibodies triggered by infection that interfere with protein S).
D65 – Disseminated intravascular coagulation [defibrination syndrome]
13507004 – Purpura fulminans
- Coumadin necrosis (warfarin necrosis) – Purpura from warfarin is more prominent on fatty areas such as the breasts, buttocks, and thighs, while purpura fulminans is usually more extensive.
- Necrotizing fasciitis
- Rocky Mountain spotted fever
- Toxic shock syndrome
- Thrombotic thrombocytopenic purpura
- Acute meningococcemia
- Over-anticoagulation with heparin or warfarin
- Bleeding into hemangiomas
- Cocaine levamisole toxicity
- Catastrophic antiphospholipid antibody syndrome