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Acute infectious purpura fulminans with Enterobacter aerogenes post-neurosurgery

Shinya Yamamoto1, Ryoji Ito1

  • 1Department of Internal Medicine, Shonan Kamakura General Hospital, 1370-1, Kamakura, Kanagawa, 247-8533, Japan.

Idcases
|March 27, 2019
PubMed

Insights

Acute infectious purpura fulminans (AIPF), a rare but fatal condition, is typically caused by specific bacteria. This case highlights a rare instance of AIPF linked to Enterobacter bacteremia, emphasizing the need for broader diagnostic considerations.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pathology

Background:

  • Acute infectious purpura fulminans (AIPF) is a severe, rapidly progressing thrombotic disorder.
  • It is most frequently associated with Neisseria meningitidis and Streptococcus pneumoniae infections.
  • Involvement of Gram-negative rods in AIPF is exceptionally rare.

Observation:

  • A 48-year-old male presented with subarachnoid hemorrhage requiring surgical intervention.
  • Post-operatively, the patient developed septic shock, multiple organ failure, and extensive skin purpura.

Findings:

  • Enterobacter aerogenes bacteremia was identified as the causative agent.
  • The patient was diagnosed with AIPF, but his condition deteriorated, leading to death on day 19.
  • Autopsy revealed widespread abscesses and thrombosis in the lungs, intestines, and kidneys.

Implications:

  • This case underscores the potential for Gram-negative bacteria, specifically Enterobacter species, to cause AIPF.
  • Highlights the importance of considering a broader range of pathogens in severe infectious purpura.
  • Emphasizes the critical and often fatal nature of AIPF, regardless of the specific bacterial etiology.
Keywords:
Enterobacter aerogenesPurpura fulminans

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