A Rare Case of Purpura Fulminans in the Setting of Klebsiella pneumoniae Bacteremia

Ariel Ruiz de Villa; Kipson Charles; Peters Okonoboh

doi:10.7759/cureus.22921

A Rare Case of Purpura Fulminans in the Setting of Klebsiella pneumoniae Bacteremia

Cureus. 2022 Mar 7;14(3):e22921. doi: 10.7759/cureus.22921. eCollection 2022 Mar.

Authors

Ariel Ruiz de Villa¹, Kipson Charles¹, Peters Okonoboh²

Affiliations

¹ Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/North Florida Regional Medical Center, Gainesville, USA.
² Internal Medicine - Critical Care, University of Central Florida College of Medicine, Graduate Medical Education/North Florida Regional Medical Center, Gainesville, USA.

Abstract

A 23-year-old man with circulatory shock associated with severe sepsis and congestive heart failure with an ejection fraction of 10% resulting in anasarca and multiorgan failure was admitted to our hospital's intensive care unit. Hours after admission, he developed a rash on his left inner thigh, which was later diagnosed as purpura fulminans (PF). Blood cultures were consistent with Klebsiella pneumoniae bacteremia, with community-acquired pneumonia being the possible source. PF is a rare and difficult-to-diagnose entity characterized by dysregulated hemostasis that is often associated with poor prognosis and fatal outcomes. To our knowledge, there are limited reports in the literature on K. pneumoniae as a cause of PF. Given the rarity of this presentation, this case will serve as an opportunity to report and discuss the pathophysiology of this disease for the benefit of physicians.

Keywords: acute infectious purpura fulminans; critical care; disseminated intravascular coagulation; klebsiella pneumoniae; purpura fulminans.

Publication types

Case Reports