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Matsuo T, Wurster S, Ivan D, Hicklen R, McConn K, Bagwell KA, Khawaja F, Chemaly RF, Kontoyiannis DP. Lethal Disseminated Mucorales Infection With Positive Blood Cultures With Purpura Fulminans Complicating Hemophagocytic Lymphohistiocytosis After Chimeric Antigen Receptor T-Cell Therapy. Open Forum Infect Dis 2024; 11:ofae647. [PMID: 39507882 PMCID: PMC11540139 DOI: 10.1093/ofid/ofae647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 10/25/2024] [Indexed: 11/08/2024] Open
Abstract
We report a case of fulminant Mucorales fungemia in a heavily immunosuppressed cancer patient with hemophagocytic lymphohistiocytosis following CD70-targeted chimeric antigen receptor T-cell therapy. Although rare, Mucorales can cause true fungemia in a broad spectrum of hosts, with a range of manifestations from isolated fungemia to fungemia being part of widely disseminated, high-burden infection.
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Affiliation(s)
- Takahiro Matsuo
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sebastian Wurster
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Doina Ivan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Rachel Hicklen
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelly McConn
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelli A Bagwell
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Fareed Khawaja
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Roy F Chemaly
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Dimitrios P Kontoyiannis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Nakanishi Y, Toyoshima H, Takeda H. A man with fever and rash. J Accid Emerg Med 2022; 39:661-696. [PMID: 35998933 DOI: 10.1136/emermed-2021-212096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Yuki Nakanishi
- Infectious Diseases, Japanese Red Cross Ise Hospital, Ise, Japan
| | | | - Hiromu Takeda
- General Medicine, Nabari City Hospital, Nabari, Japan
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Rathnayaka RMMKN, Ranathunga PEAN, Kularatne SAM, Abeywardhana KPL. Purpura fulminans following hump-nosed pit viper (Hypnale hypnale) envenoming: A rare complication of snakebites. Toxicon 2021; 202:110-114. [PMID: 34582831 DOI: 10.1016/j.toxicon.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022]
Abstract
Hump-nosed pit vipers of the genus Hypnale are highly venomous and reputed for the commonest venomous snakebites in Sri Lanka. They frequently cause local manifestations and less commonly cause systemic effects such as acute kidney injury and coagulopathy. There is no antivenom currently available in Sri Lanka for their envenoming. However, more and more complications of Hypnale bites are being recently described. Purpura fulminans, one of the rare complications of snakebites that we report following authentic Hypnale hypnale bite. A 58-year-old female was bitten by a hump-nosed viper and developed bilateral toe gangrenes, ultimately ended up with amputations. She got recovered with loss of toes in both feet for 46 days treatment at hospital.
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Affiliation(s)
- R M M K Namal Rathnayaka
- Department of Pharmacology, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Hidellana, Ratnapura, Sri Lanka; Intensive Care Unit, Teaching Hospital, Ratnapura, Sri Lanka; Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Sri Lanka.
| | | | - S A M Kularatne
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka
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Beechar VB, de la Flor C, Medford RJ. Non-typeable Haemophilus influenzae and purpura fulminans. BMJ Case Rep 2020; 13:13/7/e234880. [PMID: 32641317 DOI: 10.1136/bcr-2020-234880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Haemophilus influenzae typically causes illness and infection in the paediatric population. We report a case of a 53-year-old man who developed invasive non-typeable H. influenzae infection associated with purpura fulminans and multiorgan failure. On review of the literature, this is the first reported case of non-typeable H. influenzae causing purpura fulminans. The patient was treated with intravenous ceftriaxone 2 g/day and was eventually discharged from the hospital almost 2 months after admission. We discuss the role that infection/sepsis plays in disturbances to the coagulation cascade leading to purpura fulminans and the virulence factors that make non-typeable H. influenzae unique. Finally, we review other cases of H. influenzae associated with purpura fulminans and discuss the similarities with our case.
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Affiliation(s)
- Vivek Bhika Beechar
- Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Carolina de la Flor
- Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Richard J Medford
- Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
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Alsharif SH, Al-Omair A, Andijani F. Uncommon Location of Purpura Fulminans: Case Report and Literature Review. Case Rep Dermatol 2020; 12:5-11. [PMID: 32095125 PMCID: PMC7011717 DOI: 10.1159/000505476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 12/17/2019] [Indexed: 11/22/2022] Open
Abstract
Purpura fulminans is a critical, mostly fatal, thrombotic syndrome that requires urgent intervention. Purpura fulminans is an acute purpuric rash characterized by coagulation of the microvasculature, which leads to purpuric lesions and skin necrosis. In this report, we present a rare case of an adult patient who was admitted with rapidly forming purpura fulminans in an uncommon location.
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