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Article Excerpt
Byline: Mohammad M. Al-Hamed, MD and Hussam Sakkijha, MD
Acute infectious purpura fulminans, 1 of 3 variants of purpura fulminans, is seen most commonly in children with streptococcal, pneumococcal, meningococcal, or viral infections. The case reported here is of an adult with acute infectious purpura fulminans secondary to streptococcal infection 30 years after undergoing splenectomy for lymphoma. This case highlights the most common cause of acute infectious purpura fulminans seen in adults and in patients with hyposplenia and asplenia.
The case
The patient was a 61-year-old man who had undergone splenectomy for lymphoma 30 years previously. Since then, he had been in good health and required no treatment. He had received pneumococcal vaccination within the past 5 years, but he had not received the pneumococcal vaccine before undergoing his splenectomy.
The patient presented to the emergency department complaining of malaise and a rash on his face and legs of a few hours' duration. He had had progressive shortness of breath and was severely hypoxemic. His condition deteriorated very rapidly with progression to cardiac arrest minutes after his arrival.
He was...
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