PDF(Pubmed)
Abstract：
Purpura fulminans (PF) is a life-threatening complication of septic shock that can occur due to disseminated infections with Streptococcus pneumoniae The spleen is an important organ in the immunisation process against encapsulated bacteria. Patients with asplenia, either functional or anatomical, are therefore at increased risk of developing serious infections and complications, such as PF, if infected with such bacteria.This case report presents a woman in her late 40s with unacknowledged functional asplenia who was admitted to the hospital with signs of an acute disseminated infection causing septic shock, signs of disseminated intravascular coagulation and infectious PF. A few days after admission, the blood cultures showed growth of S. pneumoniae With early sepsis treatment, the patient survived although with some complications. Clinical presentation, investigations, differential diagnosis, treatment and outcome are presented. Treatment and early recognition of PF are presented and discussed. Relevant recognition and preventative treatment strategies for patients with asplenia are also reviewed and discussed.This case demonstrates the importance of early recognition and treatment of PF in septic patients and the importance of preventive treatment strategies for patients with asplenia to avoid serious infections and complications.
摘要：
暴发性紫癜（PF）是感染性休克的危及生命的并发症，可能是由于肺炎链球菌的播散性感染而发生的。脾脏是针对包裹细菌的免疫过程中的重要器官。有脾的患者,无论是功能性的还是解剖学的，因此，发生严重感染和并发症的风险增加，例如PF，如果感染了这种细菌。该病例报告介绍了一名40多岁的女性，患有未确认的功能性脾，入院时出现急性播散性感染，导致感染性休克。弥散性血管内凝血和感染性PF的迹象。入院后几天，血培养显示肺炎链球菌的生长与早期败血症治疗，尽管有一些并发症，但患者幸存下来。临床表现,调查,鉴别诊断,介绍了治疗和结果。提出并讨论了PF的治疗和早期识别。还回顾并讨论了对无脾患者的相关识别和预防性治疗策略。此病例证明了在败血症患者中早期识别和治疗PF的重要性，以及对无脾患者采取预防性治疗策略以避免严重感染和并发症的重要性。
