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Potentially life-threatening emergency
Purpura fulminans in Adult
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Other Resources UpToDate PubMed
Potentially life-threatening emergency

Purpura fulminans in Adult

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Contributors: Philip I. Song MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Purpura fulminans is a severe, often fatal condition that usually follows disseminated intravascular coagulation (DIC) from a bacterial infection, commonly Neisseria meningitidis, and results in skin necrosis. Although it is primarily seen in children, purpura fulminans can occur in patients of all ages.

In adults, purpura fulminans usually occurs in the setting of acute infection. Neisseria and varicella are the two most common causes, but pneumococci, measles, staphylococci, and Group A or B beta-hemolytic streptococci are also causes. Acute illness presents as a septic-appearing patient 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 post-infectious 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).

Codes

ICD10CM:
D65 – Disseminated intravascular coagulation [defibrination syndrome]

SNOMEDCT:
13507004 – Purpura fulminans

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 04/10/2017
Last Updated: 05/30/2017
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Potentially life-threatening emergency
Purpura fulminans in Adult
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Purpura fulminans : Chills, Fever, Gangrene, Patient appears systemically ill - toxic, Ecchymosis, HR increased, BP decreased
Clinical image of Purpura fulminans
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