title: A case of purpura fulminans caused by Hemophilus influenzae complicated by reversible cardiomyopathy.
abstract: Here, we report a case of a 41-year-old male diagnosed as septic shock with purpura fulminans (PF) infection. The causative organism was β-lactamase-negative ampicillin-resistant Hemophilus influenzae. He developed fulminant cardiac dysfunction approximately 1 h after admission, and the cause was considered to be septic cardiomyopathy. Blood pressure and oxygenation were maintained at adequate levels with the aid of extracorporeal membrane oxygenation (ECMO). The cardiac dysfunction was reversible, and he was successfully weaned from ECMO on day 12 of hospitalization. However, he needed amputation for all extremities because the infection spread to his limbs and eventually, succumbed to sepsis caused by empyema on day 34 of hospitalization. To the best of our knowledge, this is only the second case of PF caused by H. influenzae in an adult to be reported worldwide.
authors.affiliation: Trauma and Acute Critical Care Medical Center, Medical Hospital of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Endo
authors.affiliation: Trauma and Acute Critical Care Medical Center, Medical Hospital of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiraishi
authors.affiliation: Trauma and Acute Critical Care Medical Center, Medical Hospital of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Aiboshi
authors.affiliation: Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Chiba, 296-8602 Japan ; UQ Centre for Clinical Research, The University of Queensland, Herston, Brisbane, St Lucia Queensland, 4072 Australia.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Trauma and Acute Critical Care Medical Center, Medical Hospital of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Otomo
keywords: Amputation; Disseminated intravascular coagulation; Symmetric peripheral gangrene