Purpura Fulminans Due to Escherichia coli Septicemia in Relapsed Acute Myeloid Leukemia: An Unusual Case of Protein C Deficiency and Disseminated Intravascular Coagulation
Purpura fulminans (PF) is a rare and life-threatening condition characterized by rapid development of cutaneous microvascular thrombosis and skin necrosis, typically associated with disseminated intravascular coagulation (DIC). Here, we present a case of PF in an adult patient with relapsed acute myeloid leukemia (AML) who developed <i>Escherichia coli (E. coli)</i> septicemia. The patient's coagulopathy, including marked protein C deficiency, and immunosuppression required resuscitation, targeted antibiotic therapy, correction of hemostatic abnormalities, and surgical management. This case highlights the challenges of managing protein C deficiency and immunosuppression in PF, demonstrating how these interventions are critical to preventing progression and improving outcomes in this complex context.
Authors
- Tarek Zieneldien (ORCID: https://orcid.org/0000-0002-0230-4951)
- Sophia Ma (ORCID: https://orcid.org/0000-0003-2690-1694)
- John Norman Greene (ORCID: https://orcid.org/0000-0002-9828-8545)
- Ana Paula Velez (ORCID: https://orcid.org/0000-0002-5093-6902)
- Arun D. Singh (ORCID: https://orcid.org/0000-0001-9411-0320)
- Karanbir Singh (ORCID: https://orcid.org/0000-0002-4595-5586)
- Janice Kim (ORCID: https://orcid.org/0000-0001-5096-4068)
Institutions
- Johns Hopkins University (US)
- Johns Hopkins Medicine (US)
- Government Medical College, Amritsar (IN)
- Moffitt Cancer Center (US)
- Michigan State University (US)
Publication Details
- Journal
- Cureus
- Published
- 2025-11-27
- DOI
- https://doi.org/10.7759/cureus.97951
- Primary Topic
- Sepsis Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00