Purpura fulminans on the nose with septic abortion.

Intensive Care Med

Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Published: June 2015

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http://dx.doi.org/10.1007/s00134-014-3633-9DOI Listing

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Article Synopsis
  • Neonatal protein C deficiency can lead to severe conditions like purpura fulminans and has a generally poor prognosis, especially regarding vision.
  • In a study of 38 survivors with biallelic PROC variants, a significant number suffered from severe visual impairments: 23 were totally blind, and only one had normal vision.
  • Prenatal intervention is crucial to enhance visual outcomes, as ocular lesions often present early in these cases, affecting the eyes before other organs.
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When an understanding of pathogenesis exists, skin lesions that have the appearance of blood in the skin can provide insight into the mechanisms leading to a systemic process that results in cutaneous manifestations. Of the vascular disturbances of the skin that occur in critically ill patients, some result from a non-hemorrhagic process while occurs represent bleeding into the skin. The lesions of livedo, petechiae, purpura, and ecchymoses can be approached from such a perspective.

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Background: Acute infectious purpura fulminans (AIPF) is a rare but potentially fatal postoperative complication characterised by rapidly progressing disseminated intravascular coagulation (DIC), widespread purpura, and multi-organ dysfunction. Despite its severe and critical outcomes, the literature on this condition in the postoperative context is limited.

Objectives: This study aimed to analyse and evaluate the incidence, clinical presentation, laboratory findings, management strategies, and outcomes of postoperative AIPF in patients who underwent various surgical procedures.

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