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Query: UMLS:C0012739 (
disseminated intravascular coagulation
)
8,673
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Purpura fulminans
is a rare syndrome of intravascular thrombosis and hemorrhagic infarction of the skin that is rapidly progressive and accompanied by vascular collapse and
disseminated intravascular coagulation
. It usually occurs in children, but this syndrome has also been noted in adults. The purpose of this collective review is to provide modern concepts on the diagnosis and treatment of neonatal purpura fulminans, idiopathic purpura fulminans, and acute infectious purpura fulminans. There are three forms of this disease that are classified by the triggering mechanisms. First, neonatal purpura fulminans is associated with a hereditary deficiency of the natural anticoagulants Protein C and Protein S as well as Antithrombin III. Idiopathic purpura fulminans usually follows an initiating febrile illness that manifests with rapidly progressive purpura. Deficiency of Protein S is considered to be central to the pathogenesis of this form of the disease. The third and most common type of purpura fulminans is acute infectious purpura fulminans. The mortality rate has decreased with better treatment of secondary infections, supportive care, and new treatments, but it remains a disabling condition often requiring major amputations.
...
PMID:Modern concepts of the diagnosis and treatment of purpura fulminans. 1865 66
Purpura Fulminans
is a severe disorder of acute onset with high morbidity and mortality. It is characterized by
DIC
with thrombocytopenia, hyofibrinogenemia, hypothrombinemia and anemia. It most often occurs in young with sudden appearance of symmetrical, tender, ecchymotic skin lesions usually involving the lower extremities. An infectious and noninfectious etiology has been proposed. Early recognition and early therapy with appropriate antibiotics and heparin is known to limit both morbidity and mortality. This article reports 5 cases of
Purpura Fulminans
treated at our centre with review of etiology, pathogenesis, clinical features and treatment.
...
PMID:Spectrum of purpura fulminans. 1939 Oct 8
Purpura fulminans
is an acute and frequently fatal disorder characterized by sudden onset of progressive cutaneous hemorrhage and necrosis due to dermal vascular thrombosis and
disseminated intravascular coagulation
. The authors present a neonate with extensive purpura fulminans due to group B streptoccoccal septicemia and evaluated the attributable clinical mortality and morbidity of this potentially lethal syndrome. Clinicians especially neonatologists should be aware that early-onset sepsis of group B Streptococcus in the newborn infant with purpura fulminans could be a cause of maternal carriage due to colonization of this pathogen microorganism.
...
PMID:Neonatal purpura fulminans secondary to group B streptococcal infection. 2079 72
Purpura fulminans
(PF) is a haematological emergency in which there is skin necrosis and
disseminated intravascular coagulation
. This may progress rapidly to multi-organ failure caused by thrombotic occlusion of small and medium-sized blood vessels. PF may complicate severe sepsis or may occur as an autoimmune response to otherwise benign childhood infections. PF may also be the presenting symptom of severe heritable deficiency of the natural anticoagulants protein C or protein S. Early recognition and treatment of PF is essential to reduce mortality and to prevent major long-term health sequelae. However, management strategies require accurate identification of the underlying cause. This review focuses on the clinical features, differential diagnosis and laboratory features of the range of PF disorders and includes expert consensus opinion about immediate and on-going management.
...
PMID:Purpura fulminans: recognition, diagnosis and management. 2123 82
Purpura fulminans
is a syndrome characterized by hemorrhagic infarction of the skin and underlying soft tissue as a result of
disseminated intravascular coagulation
and intravascular thrombosis. In this study, the authors report their experience with surgical intervention for acute infectious purpura fulminans (AIPF). A retrospective chart review was performed including all patients diagnosed with AIPF from January 1, 2006, to December 31, 2008, and treated at an academic medical center. Primary endpoints of interest were overall survival rate and the need for and level of eventual amputation. Improvement in limb perfusion was included as a secondary endpoint. Nine patients were diagnosed with AIPF at the authors' institution during a 3-year period, and seven of these diagnoses were made within 12 months. Overall mortality was 44% (5/9). Amputation was required in 80% of survivors (4/5). All patients explored within 24 hours of diagnosis had evidence for compartment syndrome with visible bulging muscle on fascial release. AIPF is a devastating disease with significant mortality and morbidity primarily related to the loss of multiple limbs. This study suggests that early diagnosis and surgical intervention in the form of compartment release and sympathectomy should be performed concurrently with the initial treatment of sepsis to minimize amputations in surviving patients.
...
PMID:Surgical management of acute infectious purpura fulminans. 2123 23
Purpura fulminans
(PF) and deep vein thrombosis are rare complications secondary to chicken pox disease. The presence of antibodies reflects an ongoing immunological process and requires specialized management. The present study reports a 4-year-old boy with no medical history who presented with purpura on the legs 10 days after chicken pox eruption. Laboratory tests showed a
disseminated intravascular coagulation
associated with low plasma protein C and S activities, and the presence of anti-protein S antibodies. A replacement therapy with protein C infusions and fresh frozen plasma was prescribed. The patient also underwent regular sessions of hyperbaric oxygen followed by the surgery. Fourteen days after the beginning of the purpuric lesions, he presented deep vein thrombosis (DVT) of the lower limbs and was treated with unfractionated heparin. This case report illustrates the pathophysiology of DVT occurring in a patient with chicken pox disease (i.e., acquired protein C and S deficiencies and anti-protein S autoantibodies) and emphasizes the utility of thrombophilia testing in order to better adapt treatment.
...
PMID:[Varicella-associated purpura fulminans and deep vein thrombosis: a pediatric case report]. 2161 51
Purpura fulminans
is an acute illness characterized by rapidly progressive dermal vascular thrombosis, leading to hemorrhagic necrosis of the skin. Here, we describe the case of a healthy woman who developed acute
disseminated intravascular coagulation
(
DIC
) with purpura fulminans after intramuscular administration of a single dose of ketorolac. Review of literature showed only one case description of non-steroidal anti-inflammatory drug (diclofenac)-related purpura fulminans with
DIC
.
...
PMID:Adult purpura fulminans associated with non-steroidal anti-inflammatory drug use. 2165 44
Purpura fulminans
and venous thrombosis are rare complications of chickenpox. We report the case of a 6 year old with no history individuals who experienced cerebral thrombophlebitis, 3 weeks after varicella. MRI, performed at admission, has objectified longitudinal sinus thrombosis and a frontal parenchymal hematoma law. Meanwhile, a recent varicella seroconversion was demonstrated. The assessment of thrombophilia, meanwhile, has objectified a significant decrease in free protein S and activity, without associated
DIC
. Origin acquired this deficit was confirmed by the detection of antibodies (IgG and IgM) against the total protein S by ELISA. After evaluation of the benefit/risk only anticoagulation was initiated. The clinical and biological evolution was favorable, with rapid normalization of the S protein and decrease of anti-protein S. Many studies report the presence of anti-protein S in young children at the waning of chickenpox, without their exact frequency is determined. The decrease in protein S they cause leads to a transient hypercoagulable state may result in different clinical pictures. Cases of purpura fulminans seem more frequent when venous thrombosis isolated post chickenpox, sometimes atypical, appear rare.
...
PMID:[Post-varicella cerebral thrombophlebitis with anti-protein S: report of a pediatric case]. 2229 43
Purpura fulminans
is a rare syndrome of intravascular thrombosis and hemorrhagic infarction of the skin that is rapidly progressive and is accompanied by vascular collapse and
disseminated intravascular coagulation
. It usually occurs in children, but this syndrome has also been noted in adults. The three forms of this disease are classified by the triggering mechanisms. We describe three classical cases of purpura fulminans of the three classical prototypes treated at our center and their varied clinical outcomes. We also describe a case of acute infectious purpura fulminans secondary to systemic leptospirosis which to our best knowledge is the first reported case in world literature. The various treatment options for purpura fulminans have also been reviewed.
...
PMID:Spectrum of purpura fulminans: report of three classical prototypes and review of management strategies. 2242 68
Purpura fulminans
(PF) is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory signs of
disseminated intravascular coagulation
(
DIC
). Our case describes a 37-year-old previously healthy man who presented with 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory workup revealed
DIC
without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF) biochemical analysis. There was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealed Streptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients with otherwise unexplained
DIC
as this may be an early manifestation of infection. PF is a clinical diagnosis that requires early recognition and prompt empirical treatment, especially, in patients with progressive altered mental status, ecchymotic skin rash, and
DIC
.
...
PMID:Purpura Fulminans Secondary to Streptococcus pneumoniae Meningitis. 2256 89
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