title: Purpura fulminans and late onset group B streptococcal sepsis in a premature twin.
abstract: BACKGROUND
  Purpura fulminans (PF) is a skin manifestation due to hemorrhagic infarction caused by intravascular thrombosis secondary to bacterial infections or deficiency of anticoagulants such as protein C and protein S. Neonatal PF is a rare but potentially disabling disorder associated with a high mortality and severe long term morbidity in those who survive.
  
  
  METHODS
  We report a case of a premature infant who developed extensive PF due to late onset group B streptococcus sepsis. Despite early identification and initiation of antibiotic therapy in our patient, PF progressed rapidly, leading to autoamputation of fingers and toes and severe brain injury.
  
  
  CONCLUSIONS
  In conclusion, our case highlights the severe sequelae of PF due to late onset GBS sepsis in a premature infant.
authors.affiliation: Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Avanikkha
authors.initials: A
authors.lastname: Elayappen
authors.affiliation: Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Jain
authors.affiliation: Department of Pathology, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Loeffelholz
authors.affiliation: Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Janak
authors.initials: J
authors.lastname: Patel
keywords: GBS; coagulation; meningitis; neonate; purpura fulminans; serotype Ia