Abstract

A middle-aged woman presented from an outside hospital with a diagnosis of Neisseria meningitidis and meningococcemia. A nonpalpable purpuric skin rash evolved into multiple wounds, with gradual necrosis of bilateral lower and upper extremities. Throughout the course of hospitalization, the patient developed ventricular tachycardia, normocytic anemia, thrombocytosis, Clostridium difficile infection, depression, and transient right eye blindness. The finding of decreased CH50 in the complement cascade was considered as the potential cause of the meningococcemia. The subsequent ischemia and necrosis of extremities were attributed to the systemic effect and trauma ensuing from N. meningitidis.

Links

Publisher Full Text

Authors

Herzog JL, Morgan KP, Paden MH, Stone PA

Institution

Highlands Presbyterian/St. Luke's Denver Podiatric Surgical Residency, Denver, CO, USA.

Source

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 49:5 pg 489.e5-9

MeSH

Amputation
Anti-Bacterial Agents
Blindness
Clostridium difficile
Complement System Proteins
Depression
Disseminated Intravascular Coagulation
Enterocolitis, Pseudomembranous
Extremities
Female
Humans
Hyperbaric Oxygenation
Ischemia
Meningococcal Infections
Middle Aged
Necrosis
Negative-Pressure Wound Therapy
Neisseria meningitidis
Purpura Fulminans
Skin
Skin Transplantation

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20619693