Journal Article

Sepsis-induced purpura fulminans caused by Pasteurella multocida

Oliveira, Nelson, Cássio, Isabel, Costa, Humberto, Borges, Lisa

2014

Overview

A 52-year-old man was admitted with a cutaneous rash associated with septic shock and multiorganic failure, 6 days after a dog bite. He was started on empiric antibiotherapy and supportive measures. The patient's condition aggravated, with need for invasive mechanical ventilation and intermittent haemodialysis, and evolution from a petechiae-like rash to purpura and gangrene, culminating in bilateral lower limb amputation. The blood cultures revealed only Pasteurella multocida, after 10 days of incubation. P multocida infection is a rare cause of soft tissue infection that subsides with oral antibiotherapy. Infections causing sepsis are rare and appear in immunocompromised patients. Purpura fulminans induced by sepsis is a rare, life-threatening disorder. This syndrome should be recognised promptly, so early treatment is instituted. We found no case reports of purpura fulminans caused by Pasteurella infections in our literature review.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: 51-70 years / Amputation / Animal bites / Animals / Antibiotics / Arthritis / Bites and Stings - complications / Blood platelets / Debridement / Diabetes / Dogs / Endocarditis / Europe (West) / Gangrene / Hematology / Hemodialysis / Humans / Infections / Kidney diseases / Leukocytes / Liver / Male / Medical prognosis / Meningitis / Microorganisms / Middle Aged / Mortality / Pasteurella Infections - etiology / Pasteurella multocida - isolation & purification / Patients / Proteins / Purpura / Purpura Fulminans - etiology / Rare disease / Sepsis / Shock, Septic - etiology / Thrombocytopenia / Urine / Ventilators / White