title: Disseminated intravascular coagulation, meningococcal infection, and ischemic changes affecting the lower extremities: a case study.
abstract: A middle-aged woman presented from an outside hospital with a diagnosis of Neisseria meningitidis and meningococcemia. A nonpalpable purpuric skin rash evolved into multiple wounds, with gradual necrosis of bilateral lower and upper extremities. Throughout the course of hospitalization, the patient developed ventricular tachycardia, normocytic anemia, thrombocytosis, Clostridium difficile infection, depression, and transient right eye blindness. The finding of decreased CH50 in the complement cascade was considered as the potential cause of the meningococcemia. The subsequent ischemia and necrosis of extremities were attributed to the systemic effect and trauma ensuing from N. meningitidis.
authors.affiliation: Highlands Presbyterian/St. Luke's Denver Podiatric Surgical Residency, Denver, CO, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Herzog
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Morgan
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Paden
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stone
mesh_terms: D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology; D016360:Clostridioides difficile / Q000302:isolation & purification; D003165:Complement System Proteins / Q000172:deficiency*; D003863:Depression / Q000209:etiology; D062109:Dermatologic Surgical Procedures; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000628:therapy; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000188:drug therapy; D005121:Extremities / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D007511:Ischemia / Q000209:etiology / Q000628:therapy; D008589:Meningococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000628:therapy; D054843:Negative-Pressure Wound Therapy; D009345:Neisseria meningitidis / Q000302:isolation & purification; D055665:Purpura Fulminans / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012867:Skin / Q000098:blood supply / Q000473:pathology; D016038:Skin Transplantation
chemical_list: D000900:Anti-Bacterial Agents; D003165:Complement System Proteins