Acute infectious purpura fulminans

Introduction
Acute infectious purpura fulminans is a rare life-threatening complication of sepsis, which rapidly progresses to acute circulatory failure due to intravascular thrombosis and extensive haemorrhagic purpura associated with disseminated intravascular coagulation and multiple organ failure.

Case Report
A 43-year-old man reported to the emergency room because of dyspnoea following traumatic splenectomy. On admission, the patient reported malaise, fever and chills. The incident happened within a few hours to the development of septic shock. A dermatological examination revealed bleeding spots that did not blanch under pressure, localized mainly on the face and genitals. Empirical antibiotic therapy with vancomycin, cefotaxime and metronidazole was initiated, and then the antibiotic therapy was changed to ceftriaxone. There was a rapid progression that required an amputation of the lower legs.

Conclusions
Acute infectious purpura fulminans is a life-threatening disease that requires intensive treatment, but early cutaneous manifestations may facilitate diagnosis and appropriate management.