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Disseminated intravascular coagulation, meningococcal infection, and ischemic changes affecting the lower extremities: a case study.

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.

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  • 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