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American Journal of Emergency Medicine 2012-Jul

Purpura fulminans caused by community-associated methicillin-resistant Staphylococcus aureus.

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Casimir J Fitzgerald
Thomas V Pranikoff
Gregory A Ross
Steven Mou
Laurence B Givner
Avinash K Shetty

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Abstract

Sepsis-induced purpura fulminans is a rare but life-threatening condition characterized by rapidly progressive hemorrhagic infarction of the skin due to dermal vascular thrombosis resulting in tissue loss and severe scarring. Although most commonly related to meningococcal or invasive group A streptococcal disease, it may also be caused by several other bacterial or viral pathogens including Pneumococcus and Varicella. Purpura fulminans associated with Staphylococcus aureus sepsis is rare but has been reported in adults. However, the syndrome is very unusual in children, and to our knowledge, only 2 cases of staphylococcal purpura fulminans have been reported in children, both due to methicillin-susceptible S aureus in the United Kingdom. We report the first well-described case of purpura fulminans due to community-associated methicillin-resistant S aureus in a child.

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