Recognition and Management of Acute Purpura Fulminans: A Case Report of a Complication of Neisseria meningitidis Bacteremia

Purpura fulminans (PF) is a rare, potentially fatal complication of disseminated intravascular coagulation that is commonly associated with severe bacterial infections such as those caused by the bacterium Neisseria meningitidis. With the advent of vaccination, meningococcal disease has become infrequent, with a reported incidence of 1 case per 100,000 people per year. PF is an even rarer phenomenon that is only found in approximately 10 to 20% of patients with meningococcal septicemia. PF can cause irreversible tissue necrosis within 48 hours and, in severe cases, death. Early recognition is crucial as PF has a mortality rate as high as 60% in patients with meningococcal disease. Prompt recognition, treatment of the underlying cause, vigorous skin care, and multispecialty collaboration are required for optimal management of PF, though morbidity and mortality remain high as there is no cure for adult PF. We present a case of acute PF in a patient who presented with septic shock secondary to Neisseria bacteremia.