A 75-year-old woman was admitted to our department due to worsening of left lower extremity pain with purpura. She had been on glucocorticoids for the treatment of aplastic anemia. She was diagnosed with septic shock, and vancomycin and meropenem were initiated. A symmetrical purpuric rash was noted on day 3 over the abdomen and bilateral lower extremities along with gangrene of the tips of her toes, indicating acute infectious purpura fulminans (AIPF) (Picture 1-3). Blood and wound cultures revealed Klebsiella oxytoca (Picture 4). Despite intensive care, she ultimately succumbed to sepsis with progressive gangrene. AIPF characterized by an abrupt onset of cutaneous hemorrhaging and disseminated intravascular coagulation is a fatal dermatological emergency seen in children or immunocompromised adults (1). In Japan, the common pathogens causing AIPF are Streptococcus pneumonia and Neisseria meningitides (2). To our knowledge, this is the first report of AIPF caused by K. oxytoca.
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Written informed consent was obtained from the patient for the publication of the case history and accompanying images.
The authors state that they have no Conflict of Interest (COI).
References
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