ArticleIDCases2016
Fatal purpura fulminans and Waterhouse-Friderichsen syndrome from fulminant Streptococcus pneumoniae sepsis in an asplenic young adult.
Article in IDCases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Fatal waterhouse-friderichsen syndrome at autopsy: a systematic review and forensic diagnostic framework.International journal of legal medicine · 2026Review
- Necrotizing Fasciitis Caused by Serotype 7C Streptococcus pneumoniae in Overwhelming Post-splenectomy Infection.Internal medicine (Tokyo, Japan) · 2026Article
- Clinico-Etiological Study of Purpura Fulminans: Experience from a Tertiary-Care Children Hospital.Indian dermatology online journal · 2026Article
- The Role and Safety of Aluminum Adjuvants in Childhood Vaccines.Pediatrics · 2026Review
- Purpura fulminans in a hyposplenic patient arising from pneumococcal sinusitis.BMJ case reports · 2023Article
- The Impact of Standardized Infectious Diseases Consultation on Postsplenectomy Care and Outcomes.Open forum infectious diseases · 2022Article
- Waterhouse-Friderichsen Syndrome with Bilateral Adrenal Hemorrhage Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteremia in an Adult Patient with History of Intravenous Drug Use.The American journal of case reports · 2022Article
- Pneumococcal purpura fulminans in a 25-year-old patient with liver cirrhosis due to autoimmune hepatitis.IDCases · 2022Article
- Adrenal hemorrhage and hemorrhagic masses; diagnostic workup and imaging findings.The British journal of radiology · 2021Review
- Fatal Waterhouse-Friderichsen syndrome in an adult due to serogroup YBMJ case reports · 2021Article
- Septic Shock and Purpura Fulminans Due to Streptococcus pneumoniae Bacteremia in an Unvaccinated Immunocompetent Adult: Case Report and Review.The American journal of case reports · 2020Review
- [Acute fever with rash, necrosis, and bullae in both lower extremities in a 12-year-old girl].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2020Article
- Sepsis and septic shock: endothelial molecular pathogenesis associated with vascular microthrombotic disease.Thrombosis journal · 2019Review
- A patient with a rapidly lethal pneumonia after a visit to a touristic area in rural Leon (Spain).Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2018Article
- Successful Treatment of Severe Purpura Fulminans With Anakinra.Pediatric dermatologyArticle
- Post-Infectious Purpura Fulminans in a Healthy Child: A Case Report.Case reports in dermatologyArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Asplenic patients are at increased risk for sepsis and fulminant infection. Sepsis in these patients is typically secondary to encapsulated bacteria, with Streptococcus pneumoniae being the most frequent pathogen. Rare complications of severe sepsis include purpura fulminans and bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). We present the case of a 36-year-old woman, healthy except for splenectomy years prior for idiopathic thrombocytopenic purpura treatment, who presented with fever. Upon presentation to our hospital, three hours after symptoms onset, she had purpura fulminans and shock. Despite timely antimicrobials and maximal resuscitative efforts, her disease progressed and she expired 12 hours after symptoms onset. Autopsy revealed bilateral adrenal hemorrhage; acute adrenal crisis likely contributed to her refractory shock. Prior to her presentation, she had not received guideline-based post-splenectomy care. Sepsis in asplenic patients can be fulminant and rapidly fatal. Streptococcus pneumoniae remains the most frequent cause, despite decreasing rates in recent years related to widespread pneumococcal vaccination. Guideline-based vaccinations and "pill-in-pocket" therapy can be life-saving for asplenic patients. Purpura fulminans represents an extreme manifestation of disseminated intravascular coagulation, is more common in asplenic patients, and portends a poor prognosis. Waterhouse-Friderichsen syndrome can be seen concurrently with purpura fulminans and further portends a poor prognosis; pre-mortem diagnosis requires a high index of suspicion.
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