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Purpura Fulminans

Purpura Fulminans Abstract Infection is an important cause of purpura in infants and children. The purpuric manifestations of infectious diseases such as rubeola, varicella, infectious mononucleosis, tuberculosis, or cat scratch fever may be of interest to the physician as merely a visible suggestion of host sensitization to a bacterial or viral antigen. Following cases of scarlet fever or rubeola or with a meningococcal sepsis, there can occur a rare and overwhelming form of purpura rapidly causing death. This severe confluent purpura results in local tissue death and forms the clinical syndrome of purpura fulminans or purpura gangrenosa. Guelliot1 first recorded its description in 1884. Approximately 100 cases of this syndrome have been reported in the literature with a mortality rate of 92%. Purpura fulminans is a rare complication of scarlet fever, having been seen only 4 times in over 72,000 cases observed by several groups of authors.2,3 We feel that the References 1. Guelliot, A.: Note sur 3 Cas de purpura infectieux foudroyant , Union méd. et scient. nordest 8:25, 1884. 2. Hunt, L. W.: Hemorrhagic Purpura in Scarlet Fever , Am. J. Dis. Child. 56:1086, 1938.Crossref 3. Dick, G.; Miller, E. M., and Edmondson, H.: Severe Purpura with Gangrene of Lower Extremity Following Scarlet Fever: Recovery After Amputation , Am. J. Dis. Child. 47:374, 1934.Crossref 4. Chambers, W. N.; Holyoke, J. B., and Wilson, R. F.: Purpura Fulminans , New England J. Med. 247:933, 1952.Crossref 5. Koller, F.; Gasser, C.; Krüsi, G., and de Muralt, G.: Purpura fulminans nach Scharlach mit Faktor V-Mangel und Antithrombinüberschuss , Acta haemat. 4:33, 1950.Crossref 6. Dunn, H. G.: Gangrenous Purpura and Its Occurrence in Meningococcal Septicemia , Arch. Dis. Childhood 26:184, 1951.Crossref 7. Wintrobe, M. M.: Clinical Hematology , Ed. 3, Philadelphia, Lea & Febiger, 1951, pp. 738-772. 8. Hudson, J. B.; Weinstein, L., and Chang, T-W.: Thrombocytopenic Purpura in Measles , J. Pediat. 48:48, 1956.Crossref 9. Murray, R. C., and Quick, A. J.: Purpura Fulminans , Marquette M. Rev. 22:122, 1957. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1959.02070010200008
Publisher site
See Article on Publisher Site

Abstract

Abstract Infection is an important cause of purpura in infants and children. The purpuric manifestations of infectious diseases such as rubeola, varicella, infectious mononucleosis, tuberculosis, or cat scratch fever may be of interest to the physician as merely a visible suggestion of host sensitization to a bacterial or viral antigen. Following cases of scarlet fever or rubeola or with a meningococcal sepsis, there can occur a rare and overwhelming form of purpura rapidly causing death. This severe confluent purpura results in local tissue death and forms the clinical syndrome of purpura fulminans or purpura gangrenosa. Guelliot1 first recorded its description in 1884. Approximately 100 cases of this syndrome have been reported in the literature with a mortality rate of 92%. Purpura fulminans is a rare complication of scarlet fever, having been seen only 4 times in over 72,000 cases observed by several groups of authors.2,3 We feel that the References 1. Guelliot, A.: Note sur 3 Cas de purpura infectieux foudroyant , Union méd. et scient. nordest 8:25, 1884. 2. Hunt, L. W.: Hemorrhagic Purpura in Scarlet Fever , Am. J. Dis. Child. 56:1086, 1938.Crossref 3. Dick, G.; Miller, E. M., and Edmondson, H.: Severe Purpura with Gangrene of Lower Extremity Following Scarlet Fever: Recovery After Amputation , Am. J. Dis. Child. 47:374, 1934.Crossref 4. Chambers, W. N.; Holyoke, J. B., and Wilson, R. F.: Purpura Fulminans , New England J. Med. 247:933, 1952.Crossref 5. Koller, F.; Gasser, C.; Krüsi, G., and de Muralt, G.: Purpura fulminans nach Scharlach mit Faktor V-Mangel und Antithrombinüberschuss , Acta haemat. 4:33, 1950.Crossref 6. Dunn, H. G.: Gangrenous Purpura and Its Occurrence in Meningococcal Septicemia , Arch. Dis. Childhood 26:184, 1951.Crossref 7. Wintrobe, M. M.: Clinical Hematology , Ed. 3, Philadelphia, Lea & Febiger, 1951, pp. 738-772. 8. Hudson, J. B.; Weinstein, L., and Chang, T-W.: Thrombocytopenic Purpura in Measles , J. Pediat. 48:48, 1956.Crossref 9. Murray, R. C., and Quick, A. J.: Purpura Fulminans , Marquette M. Rev. 22:122, 1957.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1959

References