title: Purpura fulminans: an unusual manifestation of severe falciparum malaria.
abstract: We describe a 67-year-old Japanese woman who contracted severe falciparum malaria in sub-Saharan Africa. The patient had impaired consciousness, jaundice and acute renal failure. Most interestingly, she manifested purpura fulminans, a cutaneous sign of disseminated intravascular coagulation, which rarely develops in severe falciparum malaria. She required intensive treatment, including haemofiltration, plasma exchange and digital amputation, to recover. This case provides further evidence that purpura fulminans is a potential clinical manifestation of severe falciparum malaria.
authors.affiliation: Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kohtohbashi, Sumida-ku, Tokyo 130-8575, Japan. ykato@imcj.hosp.go.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kato
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sawada
authors.forename: Matsuhiko
authors.initials: M
authors.lastname: Suenaga
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D005078:Exchange Transfusion, Whole Blood / Q000379:methods; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000469:parasitology* / Q000628:therapy; D016778:Malaria, Falciparum / Q000150:complications*; D014195:Travel; D016896:Treatment Outcome