title: Purpura fulminans after therapeutic hypothermia in an asphyxiated neonate with streptococcemia.
abstract: OBJECTIVE
  Therapeutic hypothermia is an established therapeutic regimen in severely asphyxiated term neonates. The amount of cerebral injury is reduced resulting in an improved neurologic outcome. Therapeutic hypothermia-induced side effects mostly affect the circulatory system, kidney, and liver. However, asphyxia and hypothermia in itself reduce the hemostatic capacity of each individual organism.
  
  
  METHODS
  A case of a neonate with severe asphyxia and purpura fulminans after hypothermia is described.
  
  
  CONCLUSIONS
  Although purpura fulminans cannot be attributed to hypothermia solely, the influence of hypothermia on hemostasis may have promoted severe coagulopathy with a fatal outcome. Further studies are necessary to reveal therapeutic hypothermia as a trigger for severe coagulopathies in asphyxiated neonates, especially in those with sepsis and overt coagulopathy prior to therapeutic hypothermia.
authors.affiliation: Division of Neonatology, Department of Pediatrics, JW Goethe-University Hospital, Frankfurt, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Fischer
authors.affiliation: Division of Neonatology, Department of Pediatrics, JW Goethe-University Hospital, Frankfurt, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Allendorf
authors.affiliation: Division of Neonatology, Department of Pediatrics, JW Goethe-University Hospital, Frankfurt, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Buxmann
authors.affiliation: Division of Neonatology, Department of Pediatrics, JW Goethe-University Hospital, Frankfurt, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Weiss
authors.affiliation: Division of Neonatology, Department of Pediatrics, JW Goethe-University Hospital, Frankfurt, Germany.
authors.forename: Rolf L
authors.initials: RL
authors.lastname: Schloesser
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000628:therapy*; D016470:Bacteremia / Q000150:complications*; D003241:Consanguinity; D017809:Fatal Outcome; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000628:therapy*; D007231:Infant, Newborn; D055665:Purpura Fulminans / Q000209:etiology*; D013290:Streptococcal Infections / Q000150:complications*; D013292:Streptococcus agalactiae; D013921:Thrombocytopenia / Q000150:complications