Two cases of purpura fulminans

Purpura in infants and children

Hemorrhage into the skin (purpura) may result from abnormalities in any of the three components of hemostasis: platelets, plasma coagulation factors, and blood vessels. The morphology, size, and distribution of the hemorrhagic lesions are helpful diagnostic features. The main causes of purpura in the newborn and the more common hemorrhagic disorders in children are reviewed.

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.

Purpura fulminans with haemolytic anaemia

A 10-month-old female infant with purpura fulminans is reported. The patient had clotting abnormality compatible with consumption coagulopathy. Histopathological examination revealed the presence of microthrombi. Heparin was effective in correcting the clotting defects. The infant also suffered from microangiopathic haemolytic anaemia. She died 17 days after the onset of the illness from infection in spite of antibiotic therapy.