Cases reported "Purpura"

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1/6. purpura fulminans secondary to xanthomonas maltophilia sepsis in an adult with aplastic anemia.

    purpura fulminans is a rare disease characterized by purpura ecchymosis, hypotension, and fever associated with disseminated intravascular coagulation. It often begins as a benign infectious process and subsequently progresses to a severe, catastrophic outcome. It is recognized to originate from congenital or acquired protein c deficiency. We present an unusual case of an adult with xanthomonas maltophilia sepsis that subsequently developed into purpura fulminans with involvement of the four extremities. We discuss the importance of the protein C system in coagulation homeostasis and its relationship to purpura fulminans.
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ranking = 1
keywords = ecchymosis
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2/6. purpura fulminans.

    purpura fulminans is a rare disease that typically begins as a benign infectious process and subsequently progresses to severe sepsis, hypotension, purpura ecchymosis, and disseminated intravascular coagulation. We present an unusual case of an adult who was seen initially with pneumococcal sepsis that subsequently developed into purpura fulminans with major extremity involvement. A multidisciplinary approach is needed in the treatment of this often catastrophic disease.
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ranking = 1
keywords = ecchymosis
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3/6. protein c deficiency.

    Severe homozygous protein c deficiency is a rare but serious problem in the newborn, with a clinical presentation of purpura fulminans. We have presented such a case in an 1,870 gm female neonate. Salient clinical findings in this case include DIC associated with extensive ecchymosis and subsequent gangrene of the skin, thrombotic complications that began on the third day of life. There was no precipitating infection. The progressive gangrenous necrosis of heel and toes was refractory to heparin therapy, but there was clinical improvement after treatment with fresh frozen plasma. Our patient's level of protein C antigen was less than 3% (normal 70% to 130%). Levels of other vitamin-K-dependent factors, as well as factor v, factor VIIIC, and antithrombin iii were normal. A heterozygous protein C deficiency was documented in the mother and father. Presently the child is receiving warfarin sodium (Coumadin) therapy and is clinically stable.
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ranking = 1
keywords = ecchymosis
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4/6. purpura fulminans. Medical, surgical, and rehabilitative considerations.

    purpura fulminans is a rare catastrophic disease of childhood that begins as a seemingly benign infectious process and subsequently progresses to high fever, purpuric ecchymosis of the skin, hypotension, disseminated intravascular coagulation, and gangrene. Initial treatment consists of resuscitation with Ringer's lactate, correction of clotting parameters with heparin, avoidance of adrenergic agents, and monitoring of limbs for compartment syndromes. Of 12 patients reported here, three had fasciotomies to limit the ischemic changes, but eventually 24 amputations were performed on the group as a whole. Delayed debridement of up to three weeks was the rule in order to allow ischemic tissue to fully demarcate. Split-thickness skin grafts were used to preserve as much length as possible, particularly where open growth plates were involved. Regardless of how hopeless the situation may initially appear, with prompt recognition and institution of appropriate care the prognosis for a productive life is good.
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ranking = 1
keywords = ecchymosis
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5/6. purpura fulminans.

    purpura fulminans is a rare disease characterized by cutaneous ecchymosis, hypotension and fever associated with disseminated intravascular coagulation. It usually follows a preparatory infectious illness. A case in a 55 year old woman challenges the concept that this disease is limited to childhood. A review of 100 case reports is presented in which the often quoted high mortality of 90 per cent is found to be no longer tenable.
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ranking = 1
keywords = ecchymosis
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6/6. Autoerythrocyte sensitization syndrome with thrombocytosis.

    A case of autoerythrocyte sensitization syndrome in a 59-year-old female is reported. She had several episodes of circular ecchymoses on her left thigh. Intradermal injection of autoerythrocytes reproduced a similar ecchymosis. thrombocytosis was detected and treated with busulfan which induced a delayed improvement of the ecchymosis outbreaks over 2 years of follow-up.
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ranking = 2
keywords = ecchymosis
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