Purpura fulminans from meningococcemia mimicking Stevens-Johnson syndrome in an adult patient taking etanercept
ND Gunawardane, K Menon, J Guitart… - Archives of …, 2012 - jamanetwork.com
In the setting of meningococcal septic shock and DIC, the patient's clinical presentation was
most consistent with PF. However, given the limited purpuric component and the presence of
vaginal and oral erosions, SJS or evolving toxic epidermal necrolysis (TEN) due to antibiotic
exposure was also plausible. Skin biopsy specimens were obtained, and administration of
intravenous immunoglobulins (IVIg) was begun at a dose of 1g/kg/d. Skin biopsy specimens
revealed full-thickness epidermal necrosis, fibrin thrombi in dermal vessels, necrosis of …
most consistent with PF. However, given the limited purpuric component and the presence of
vaginal and oral erosions, SJS or evolving toxic epidermal necrolysis (TEN) due to antibiotic
exposure was also plausible. Skin biopsy specimens were obtained, and administration of
intravenous immunoglobulins (IVIg) was begun at a dose of 1g/kg/d. Skin biopsy specimens
revealed full-thickness epidermal necrosis, fibrin thrombi in dermal vessels, necrosis of …