Purpura Fulminans : A Case Series Managed at a Regional Burn Center

Purpura fulminans (PF) is a protein C deficiency disease process with a high case fatality rate; however, overall incidence of the disease remains relatively very low. The similarity between skin necrosis secondary to PF and full-thickness skin burns provides the rationale for treating PF case in a...

Full description

Saved in:
Bibliographic Details
Published in:Journal of burn care & research 2008-03, Vol.29 (2), p.411-415
Main Authors: HASSAN, Zaheed, MULLINS, Robert F, FRIEDMAN, Bruce C, SHAVER, Joseph R, ALAM, Badrul, MIAN, Mohammad A. H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Anti-Infective Agents - therapeutic use
Biological and medical sciences
Burn Units
Burns
Debridement - methods
Dermatology
Female
Fluid Therapy
Humans
Male
Medical sciences
Middle Aged
Protein C - therapeutic use
Purpura, Schoenlein-Henoch - drug therapy
Purpura, Schoenlein-Henoch - surgery
Purpura, Schoenlein-Henoch - therapy
Recombinant Proteins - therapeutic use
Retrospective Studies
Traumas. Diseases due to physical agents
Vascular disorders of the skin
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpura fulminans (PF) is a protein C deficiency disease process with a high case fatality rate; however, overall incidence of the disease remains relatively very low. The similarity between skin necrosis secondary to PF and full-thickness skin burns provides the rationale for treating PF case in a burn center. In this case series we reviewed our experiences in managing PF and their associated favorable outcomes. Retrospective chart review of five PF cases managed between September 2004 and August 2006 at our Burn Center with 100% survival. Management of cases following the standard care of the Burn Center for a full-thickness burn included antibiotics, fluid resuscitation, surgical debridement with skin grafting, and activated protein C (Drotrecogin alfa) replacement. Two patients required amputations of extremities and all had surgical debridement. One required hemodialysis and two needed both hemodialysis and positive-pressure mechanical ventilator. No patient experienced any bleeding complications during or after surgery while receiving activated protein C. Early diagnosis and treatment at a burn center may reduce mortality and morbidity and loss of extremities in PF cases.
ISSN:1559-047X
1559-0488
DOI:10.1097/BCR.0b013e3181667936