Rare presentation of rickettsial infection as purpura fulminans: a case report
Related Experiment Video
Updated: Feb 10, 2026
A Luciferase-fluorescent Reporter Influenza Virus for Live Imaging and Quantification of Viral Infection
Published on: August 14, 2019
Chamara Dalugama1, Indika Bandara Gawarammana2
1Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. chamaradalugama@yahoo.com.
Background:
Purpura fulminans is an acute life-threatening disorder characterized by intravascular thrombosis and hemorrhagic infarction of the skin complicated with disseminated intravascular coagulation. It is commonly seen in acute infections following meningococcal and streptococcal infections. Few cases of purpura fulminans following rickettsial infections have been described in the literature.
Case Presentation:
We report a case of a 55-year-old Sri Lankan woman who presented to Teaching Hospital Peradeniya with a febrile illness, headache, and myalgia that progressed to an erythematous rash starting over the bilateral lover limbs and hands and that became black and necrotic with a few hemorrhagic blebs. She had normocytic anemia, platelet clumps, and monocytosis as well as a deranged clotting profile. The result of immunofluorescence antibody testing for rickettsial immunoglobulin G was strongly positive for Rickettsia conorii with a rise in titer convalescent sera, and a diagnosis of purpura fulminans following rickettsial infection was made. The patient made an excellent recovery with chloramphenicol treatment.
Conclusions:
The treating physician should consider the rare but very treatable condition of rickettsial infection as a differential diagnosis in the etiological diagnostic workup of patients presenting with severe purpuric and hemorrhagic rash with fever.
Insights
Purpura fulminans, a severe clotting disorder, can be caused by rickettsial infections. Early diagnosis and treatment with antibiotics like chloramphenicol are crucial for recovery from this rare but treatable condition.
Area of Science:
- Infectious Diseases
- Dermatology
- Hematology
Background:
- Purpura fulminans is a rare, acute, and life-threatening condition involving skin necrosis and disseminated intravascular coagulation.
- It is typically associated with bacterial infections like meningococcal and streptococcal diseases.
- Rickettsial infections are an uncommon but documented cause of purpura fulminans.
Observation:
- A 55-year-old woman presented with fever, headache, and myalgia, rapidly progressing to a necrotic rash on her limbs and hands.
- Laboratory findings included anemia, platelet clumps, monocytosis, and abnormal clotting parameters.
- Serological testing confirmed Rickettsia conorii infection.
Findings:
- The patient was diagnosed with purpura fulminans secondary to rickettsial infection.
- Treatment with chloramphenicol resulted in a complete recovery.
- This case highlights the association between Rickettsia conorii and purpura fulminans.
Implications:
- Rickettsial infection should be considered in the differential diagnosis of patients with severe purpuric and hemorrhagic rash and fever.
- Prompt recognition and appropriate antibiotic therapy are essential for managing this potentially fatal condition.
- Further research into the pathogenesis and management of rickettsial purpura fulminans is warranted.
More Related Videos
09:49Quantitative Measurement of Relative Retinoic Acid Levels in E8.5 Embryos and Neurosphere Cultures Using the F9 RARE-Lacz Cell-based Reporter Assay
Published on: September 6, 2016
08:28Author Spotlight: Advancing Metabolomics Analysis of Rare Hematopoietic Stem Cells
Published on: February 23, 2024
Related Concept Videos
01:25Self-Presentation
02:05Self-Presentation: Self-Monitoring and Self-Handicapping
01:12Strategies of Self-Presentation I: Strategic Self-Presentation
01:29Processes of Self-Presentation
01:17Strategies of Self-Presentation II: Self-Verification
01:24Data Reporting and Recording