title: Sepsis-induced purpura fulminans caused by Pasteurella multocida.
abstract: A 52-year-old man was admitted with a cutaneous rash associated with septic shock and multiorganic failure, 6 days after a dog bite. He was started on empiric antibiotherapy and supportive measures. The patient's condition aggravated, with need for invasive mechanical ventilation and intermittent haemodialysis, and evolution from a petechiae-like rash to purpura and gangrene, culminating in bilateral lower limb amputation. The blood cultures revealed only Pasteurella multocida, after 10 days of incubation. P multocida infection is a rare cause of soft tissue infection that subsides with oral antibiotherapy. Infections causing sepsis are rare and appear in immunocompromised patients. Purpura fulminans induced by sepsis is a rare, life-threatening disorder. This syndrome should be recognised promptly, so early treatment is instituted. We found no case reports of purpura fulminans caused by Pasteurella infections in our literature review.
authors.affiliation: Department of Vascular Surgery, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Azores, Portugal.
authors.forename: Lisa
authors.initials: L
authors.lastname: Borges
authors.forename: Nelson
authors.initials: N
authors.lastname: Oliveira
authors.forename: Isabel
authors.initials: I
authors.lastname: Cássio
authors.forename: Humberto
authors.initials: H
authors.lastname: Costa
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D004285:Dogs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010326:Pasteurella Infections / Q000209:etiology*; D016979:Pasteurella multocida / Q000302:isolation & purification*; D055665:Purpura Fulminans / Q000209:etiology*; D012772:Shock, Septic / Q000209:etiology*