Purpura fulminans

Abstract

Four patients, 2 males and 2 females, 16 to 70 years in age, developed purpura fulminans associated with disseminated intravascular coagulation. Three of these had meningitis, and one had septicaemia. All the four patients had extensive confluent geometric shaped purpura of explosive onset, that was associated with haemorrhagic bullae and focal gangrene. Acral cyanosis/gangrene was seen in all the patients. However, the large arterial pulses of the involved extremities were normal. A histopathological study showed fibrin thrombi in the dermal vessel. This facilitated an early diagnosis of DIC, where initial coagulation tests were unhelpful. In spite of appropriate therapy, 3 of the patients died of DIC.