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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2006 April;72(4):249-54

language: English, Italian

Purpura fulminans during meningococcal sepsis treated with Drotrecogin alpha. A clinical case

Belloni G. 1, Ramello P. 1, Salcuni M. R. 1, Scavone L. 1, Girotto M. 2, Di Bassiano F. 2

1 Anesthesia and Intensive Care Unit City Hospital, Ivrea, Italy
2 Department of Immuno-Hematology City Hospital, Ivrea, Italy


A male patient, 29 years old, was admitted to our unit with purpura fulminans, coagulation deficiency, renal failure and subsequent septic shock accompanied by respiratory insufficiency in the absence of meningeal signs. The serum levels of endogenous protein C, ATIII and calcium were well below the norm. The bacteriological examination revealed the presence of gram-negative diplococci. The onset of adult respiratory distress syndrome (ARDS) revealed aa early complication of the meningococcal sepsis. Forty-eight hours after being admitted, the recombinant protein C infusion was started at a dose of 24 µg/kg/h for the duration of 96 h. The skin lesions regressed, starting from the ecchymosis and the edema of the face, trunk and auricular pavilions. A week after the onset of the symptomatology the chest X-ray appeared clear, the renal function had normalised, and the signs of shock had disappeared.

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