Purpura Fulminans

Etiology

  • Related to severe, systemic infection, often Neisseria Meningitidis (meningococcemia) or Pneumococcal sepsis that causes DIC
  • Can be other micro as well

Risk Factors

  • Can occur in anyone
  • Higher risk if immunocompromised, s/p splenectomy (pneumococcus, h flu), unvaccinated

Symptoms

  • Spreading, purpuric skin lesions
  • Other findings of severe illness including fever, confusion, N, V, other
  • Evolves over hours, w/high mortality unless prompt intervention

Physical Exam Findings

  • Often symmetric
  • Often petechiae
  • Fever, tachycardia, hypotension and other findings severe illness
  • Purpuric (blue/gray/purple) lesions that develop quickly in multiple areas of the body, often hands, feet, and limbs
  • Progress quickly to necrosis (black tissue)