Section 38
Chapter 37,363

Purpura fulminans caused by meningococcemia in an infant

Abbas, A.; Mujeeb, A.A.

BMJ Case Reports


ISSN/ISBN: 1757-790X
PMID: 23921694
DOI: 10.1136/bcr-2013-200265
Accession: 037362827

A 6-month-old infant presented with a 2-day history of fever, irritability and rashes. On examination, she was febrile, hypotensive and had a purpuric rash covering the face, trunk and extremities along with symmetrical black discolouration of fingers and toes of all limbs. Investigations revealed leukocytosis, thrombocytopaenia and a prolonged prothrombin time; lumbar puncture was normal. Scrapings from the rash showed Gram-negative cocci in pairs. The child was not immunised against any strain of meningococcus. Figure 1Purpuric rash involving the legs bilaterally with areas of sloughed off skin. She was treated with intravenous fluids, inotropes, ceftrixone and hydrocortisone. Her blood culture showed growth of Neisseria meningitidis sensitive to ceftriaxone and flouroquinolones. The patient became stable after 3 days of treatment and fever subsided. However, some of the skin lesions sloughed off leaving raw exposed skin; the discolouration of fingers.

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