What Is Purpura Fulminans?
Purpura fulminans is a disorder where your skin bleeds and dies rapidly (skin necrosis). The bleeding is caused by blood clots in the dermal layer (skin layer under the top layer or epidermis). The blood vessels in your skin also collapse and the proteins that cause your blood to clot become overactive. This is called disseminated intravascular coagulation (DIC).
DIC causes your body to create too many blood clots, followed by periods of bleeding. This clotting and bleeding can interfere with blood vessels bringing oxygen to your tissues. If your tissues and organs can’t get enough oxygen, they will shut down.
What Causes Purpura Fulminans?
There are multiple causes of purpura fulminans. They are bacterial infections from the following:
Meningococcus: The bacteria neisseria meningitidis that causes meningococcal meningitis. This is an infection of the thin lining that surrounds the brain and spinal cord.
Gram-negative bacilli or gram-negative bacteria: The bacteria that causes pneumonia, bloodstream infections, wound or surgical site infections, and meningitis.
Staphylococcus: Bacteria found on your skin or in your nose. Most of the time, these bacteria cause no problems or minor skin infections (called staph infections). But staph infections can turn deadly if the bacteria invade deeper into your body or into your bloodstream.
Streptococcus: A type of bacteria that causes strep infections, like strep throat, scarlet fever, impetigo, and others.
Rickettsia organisms: A type of bacteria found in ticks, lice, fleas, mites, chiggers, and mammals. They can cause Rocky Mountain spotted fever, rickettsialpox, and other fevers.
While purpura fulminans is rare, it is important that you get treatment as quickly as possible.
Symptoms of Purpura Fulminans
With purpura fulminans, your skin begins dying in the dermal layer. This causes a rash that can rapidly progress to blood filled blisters.
This process generally affects the skin and tissues—not the muscle. This symptom is an early sign of the disease process.
Doctors use a skin biopsy to diagnose purpura fulminans. A skin biopsy removes a small section of skin cells to examine them in a laboratory. If the specialists determine you have purpura fulminans, they will immediately start treatment.
Treatment for Purpura Fulminans
To treat you, specialists will try to stop the disease from progressing. To do this, they will treat the infection causing the disease. They will also treat any additional infections and remove any damaged skin tissue.
To prevent any additional infections, the team will use these hygiene methods:
- Washing hands when entering and exiting the patient’s room
- Wearing gowns, gloves, and masks (personal protective equipment or PPE)
- Restricting who can visit the patient
- Caring for the dermal skin wounds (wound care)
- Practicing personal hygiene
Surgery
Specialists will remove any infected tissue as soon as the patient's condition allows. They will cover open areas with autografts. (An autograft is a thin layer of skin taken from part of the patient’s body and placed on the damaged part of the body.) This is a permanent graft.
The patient may need amputations if their veins are too damaged to work. They may also need multiple surgeries.
Learn more about surgery at the burn center.
Wound Care
The focus of wound care is to manage the infection and any surgical wound. The type of dressing may vary depending on the type of wound.
Medical Management
Patients may require multiple procedures or medications to manage the infection. These may include the following:
- Having an IV to keep hydrated
- Taking antibiotics to control infection
- Breathing through a temporary tube to maintain the patient’s airway
- Taking medications for blood pressure
- Replacing electrolytes (potassium, sodium, phosphorus, and the like)
- Managing glucose or blood sugar
Doctors may also give the patient a temporary feeding tube to make sure they are getting enough calories for the healing process.
Pain Control & Recovery
Comfort is a top priority for our patients. The treatment team will give you pain medications as you need them.
The length of your hospital stay depends on how extensive the disease is.
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Before the patient can go home, they need to reach specific goals. The treatment team will talk about these goals throughout your stay and will evaluate your progress frequently.
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In addition to in-hospital and clinical management of burns, we provide a consultation service. This consult service is through our telemedicine program to help ensure our patients receive optimal care.
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Why does it matter that we are a verified burn center? The American Burn Association and the American College of Surgeons designed a rigorous review program that ensures verified centers offer the best care for their patients. This includes the whole patient experience from the time of injury through rehabilitation.
It also means we meet the highest quality of care available because we meet these high quality standards. The standards are for personnel qualifications, facilities resources, organizational structure, and medical care services.
