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.

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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
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article

Purpura Fulminans Due to Escherichia coli Septicemia in Relapsed Acute Myeloid Leukemia: An Unusual Case of Protein C Deficiency and Disseminated Intravascular Coagulation

Tarek Zieneldien, Sophia Ma, John Norman Greene, Ana Paula Velez et al.
Cureus
Sepsis Diagnosis and Treatment
article

Purpura Fulminans Due to Escherichia coli Septicemia in Relapsed Acute Myeloid Leukemia: An Unusual Case of Protein C Deficiency and Disseminated Intravascular Coagulation

Tarek Zieneldien, Sophia Ma, John Norman Greene, Ana Paula Velez, Arun D. Singh, Karanbir Singh, Janice Kim
article en

Abstract

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.

CureusVol. 17(11)
Johns Hopkins University (US), Johns Hopkins Medicine (US), Government Medical College, Amritsar (IN), Moffitt Cancer Center (US), Michigan State University (US)
Openalex Percentile: Top 52%
Sepsis Diagnosis and Treatment
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Purpura Fulminans Due to Escherichia coli Septicemia in Relapsed Acute Myeloid Leukemia: An Unusual Case of Protein C Deficiency and Disseminated Intravascular Coagulation — Tarek Zieneldien, Sophia Ma, et al. · Cureus (2025) | TGRS Research Map | TGRS