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- Title
Purpura Fulminans with Transient Protein C and Protein S Deficiency.
- Authors
Koturoğlu, Güldane; Vardar, Fadıl; Özkınay, Cihangir; Aslan, M.Tayyip; Onay, Hüseyin; Kavaklı, Kaan; Ferda Özkınay, Zafer Kurugöl,
- Abstract
Purpura Fulminans is a rare but devastating disease. The acute infectious type is the commonly encountered form of the disease and is responsible for about 90% of the cases. The most common etiologic factors are Neisseria Menengitidis and ß hemolytic Streptococcus among bacterial agents, and Varicella Zoster among viral infections. We present the case of a previously healthy 2.5-yearold boy with hemorrhagic skin lesions characteristic of purpura fulminans. Laboratory analyses revealed very low protein S and C levels. Blood culture revealed Staphylococcus aureus. The patient received daily replacement therapy with fresh frozen plasma for 15 days and anticoagulation with low-molecular-weight heparin for 15 days. In addition, he received Teikoplanine therapy. Despite generous plasma infusions, skin necrosis progressed rapidly into compartment syndrome which required fasciotomy and skin grafting. Protein S and Protein C remained low for 3 months despite treatment. We presented this case in order to emphasize that S. aureus should be considered among the etiologic agents of post-infectious secondary purpura fulminans, and the treatment should be considered accordingly.
- Subjects
STAPHYLOCOCCUS aureus; STAPHYLOCOCCUS; STAPHYLOCOCCAL protein A; STREPTOCOCCAL diseases; BACTERIAL diseases; NECROTIZING fasciitis; PNEUMOCOCCAL pneumonia; STREPTOCOCCACEAE; GRAM-positive bacteria; ENTEROCOCCUS
- Publication
Journal of Pediatric Infection / Çocuk Enfeksiyon Dergisi, 2008, Vol 2, Issue 3, p124
- ISSN
1307-1068
- Publication type
Article