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Rare presentation of rickettsial infection as purpura fulminans: a case report
BACKGROUND: Purpura fulminans is an acute life-threatening disorder characterized by intravascular thrombosis and hemorrhagic infarction of the skin complicated with disseminated intravascular coagulation. It is commonly seen in acute infections following meningococcal and streptococcal infections....
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5970498/ https://www.ncbi.nlm.nih.gov/pubmed/29801512 http://dx.doi.org/10.1186/s13256-018-1672-5 |
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author | Dalugama, Chamara Gawarammana, Indika Bandara |
author_facet | Dalugama, Chamara Gawarammana, Indika Bandara |
author_sort | Dalugama, Chamara |
collection | PubMed |
description | BACKGROUND: Purpura fulminans is an acute life-threatening disorder characterized by intravascular thrombosis and hemorrhagic infarction of the skin complicated with disseminated intravascular coagulation. It is commonly seen in acute infections following meningococcal and streptococcal infections. Few cases of purpura fulminans following rickettsial infections have been described in the literature. CASE PRESENTATION: We report a case of a 55-year-old Sri Lankan woman who presented to Teaching Hospital Peradeniya with a febrile illness, headache, and myalgia that progressed to an erythematous rash starting over the bilateral lover limbs and hands and that became black and necrotic with a few hemorrhagic blebs. She had normocytic anemia, platelet clumps, and monocytosis as well as a deranged clotting profile. The result of immunofluorescence antibody testing for rickettsial immunoglobulin G was strongly positive for Rickettsia conorii with a rise in titer convalescent sera, and a diagnosis of purpura fulminans following rickettsial infection was made. The patient made an excellent recovery with chloramphenicol treatment. CONCLUSIONS: The treating physician should consider the rare but very treatable condition of rickettsial infection as a differential diagnosis in the etiological diagnostic workup of patients presenting with severe purpuric and hemorrhagic rash with fever. |
format | Online Article Text |
id | pubmed-5970498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59704982018-05-30 Rare presentation of rickettsial infection as purpura fulminans: a case report Dalugama, Chamara Gawarammana, Indika Bandara J Med Case Rep Case Report BACKGROUND: Purpura fulminans is an acute life-threatening disorder characterized by intravascular thrombosis and hemorrhagic infarction of the skin complicated with disseminated intravascular coagulation. It is commonly seen in acute infections following meningococcal and streptococcal infections. Few cases of purpura fulminans following rickettsial infections have been described in the literature. CASE PRESENTATION: We report a case of a 55-year-old Sri Lankan woman who presented to Teaching Hospital Peradeniya with a febrile illness, headache, and myalgia that progressed to an erythematous rash starting over the bilateral lover limbs and hands and that became black and necrotic with a few hemorrhagic blebs. She had normocytic anemia, platelet clumps, and monocytosis as well as a deranged clotting profile. The result of immunofluorescence antibody testing for rickettsial immunoglobulin G was strongly positive for Rickettsia conorii with a rise in titer convalescent sera, and a diagnosis of purpura fulminans following rickettsial infection was made. The patient made an excellent recovery with chloramphenicol treatment. CONCLUSIONS: The treating physician should consider the rare but very treatable condition of rickettsial infection as a differential diagnosis in the etiological diagnostic workup of patients presenting with severe purpuric and hemorrhagic rash with fever. BioMed Central 2018-05-26 /pmc/articles/PMC5970498/ /pubmed/29801512 http://dx.doi.org/10.1186/s13256-018-1672-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Dalugama, Chamara Gawarammana, Indika Bandara Rare presentation of rickettsial infection as purpura fulminans: a case report |
title | Rare presentation of rickettsial infection as purpura fulminans: a case report |
title_full | Rare presentation of rickettsial infection as purpura fulminans: a case report |
title_fullStr | Rare presentation of rickettsial infection as purpura fulminans: a case report |
title_full_unstemmed | Rare presentation of rickettsial infection as purpura fulminans: a case report |
title_short | Rare presentation of rickettsial infection as purpura fulminans: a case report |
title_sort | rare presentation of rickettsial infection as purpura fulminans: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5970498/ https://www.ncbi.nlm.nih.gov/pubmed/29801512 http://dx.doi.org/10.1186/s13256-018-1672-5 |
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