Version 1
: Received: 10 July 2023 / Approved: 11 July 2023 / Online: 11 July 2023 (10:41:03 CEST)
How to cite:
Merisescu, M.M.; Jugulete, G.; Carmen, P.; Luminos, M.L. Rare Fatal Case of Purpura Fulminans with Acute Kidney Injury, Due to Pneumococcal Sepsis in Children, Associated with Multiorgan Failure. Preprints2023, 2023070711. https://doi.org/10.20944/preprints202307.0711.v1
Merisescu, M.M.; Jugulete, G.; Carmen, P.; Luminos, M.L. Rare Fatal Case of Purpura Fulminans with Acute Kidney Injury, Due to Pneumococcal Sepsis in Children, Associated with Multiorgan Failure. Preprints 2023, 2023070711. https://doi.org/10.20944/preprints202307.0711.v1
Merisescu, M.M.; Jugulete, G.; Carmen, P.; Luminos, M.L. Rare Fatal Case of Purpura Fulminans with Acute Kidney Injury, Due to Pneumococcal Sepsis in Children, Associated with Multiorgan Failure. Preprints2023, 2023070711. https://doi.org/10.20944/preprints202307.0711.v1
APA Style
Merisescu, M.M., Jugulete, G., Carmen, P., & Luminos, M.L. (2023). Rare Fatal Case of Purpura Fulminans with Acute Kidney Injury, Due to Pneumococcal Sepsis in Children, Associated with Multiorgan Failure. Preprints. https://doi.org/10.20944/preprints202307.0711.v1
Chicago/Turabian Style
Merisescu, M.M., Pavelescu Carmen and Monica Luminita Luminos. 2023 "Rare Fatal Case of Purpura Fulminans with Acute Kidney Injury, Due to Pneumococcal Sepsis in Children, Associated with Multiorgan Failure" Preprints. https://doi.org/10.20944/preprints202307.0711.v1
Abstract
Streptococcus pneumoniae is one of the associated bacteria that can cause the rare but high mortality hematological disease known as purpura fulminans (PF) in both adults and children. Patients with PF can progress quickly to sepsis and multiorgan failure, especially in immunocompromised individuals and young children. Due to the thrombotic blockage of blood arteries in PF, there is diffuse intravascular thrombosis and hemorrhagic infarction of the skin, which evolves from ecchymosis to skin necrosis, risk of limb sequelae, sepsis and fatality.
We present a case of a previously healthy 1-year and 9-month female who was admitted to the Intensive Care Unit of the National Institute of Infectious Diseases "Prof. Dr. Matei Balș"- Bucharest, Romania. The patient presented with erythematous patches on left upper limb and trunk, tachycardia, tachypnea, hypotension, anuria and altered sensorium with an indication of intubation for 8 Glasgow Coma Scale (GCS). Cerebrospinal culture grew Streptococcus pneumoniae serotype 1. She required peritoneal dialysis due to acute kidney injury (AKI) and surgeries for affected areas. After multiple organ system failures, our patient evolved rapidly to irreversible tissue necrosis and death. We aim to report a rare case of PF associated with pneumococcal meningoencephalitis in immunocompetent children to better appreciate the risk of fatal evolution when managing this disease in children. To date, few studies report favourable evolution. We discuss the etiology, rapid diagnosis and treatment of immunocompetent children with PF and the importance of interprofessional teams to increase the outcomes in patients with infectious diseases.
Keywords
Streptococcus pneumoniae; purpura fulminans; sepsis; shock; children; Acute Kidney Injury; multiple organ and system failures
Subject
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
