Purpura Fulminans in a Patient With Cirrhosis and Methicillin-Sensitive Staphylococcus aureus (MSSA) Bacteremia: Diagnostic Challenges in Coagulopathy

(MSSA) bacteremia and toxic shock syndrome (TSS). Despite treatment with antibiotics, transfusions, intravenous immunoglobulin (IVIG), and hemodialysis, he developed multiorgan failure. This case highlights that in patients with sepsis and cirrhosis, acutely worsening coagulation parameters, falling fibrinogen, and evolving purpuric or necrotic skin lesions should not be attributed to liver disease alone but should instead prompt urgent evaluation for DIC and PF. The early recognition of this distinction is essential to guide timely multidisciplinary intervention in this rare but devastating complication.

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Publication Details

Journal
Cureus
Published
2026-04-03
DOI
https://doi.org/10.7759/cureus.106365
Primary Topic
Sepsis Diagnosis and Treatment
Type
article
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article

Purpura Fulminans in a Patient With Cirrhosis and Methicillin-Sensitive Staphylococcus aureus (MSSA) Bacteremia: Diagnostic Challenges in Coagulopathy

Christopher Wexler, Christopher R. Chedid, Andrew Carbajal, Katherine Blaise et al.
Cureus
Sepsis Diagnosis and Treatment
article

Purpura Fulminans in a Patient With Cirrhosis and Methicillin-Sensitive Staphylococcus aureus (MSSA) Bacteremia: Diagnostic Challenges in Coagulopathy

Christopher Wexler, Christopher R. Chedid, Andrew Carbajal, Katherine Blaise, Taylor L Dartez, Donnell D White, Melanie Bienvenue
article en

Abstract

(MSSA) bacteremia and toxic shock syndrome (TSS). Despite treatment with antibiotics, transfusions, intravenous immunoglobulin (IVIG), and hemodialysis, he developed multiorgan failure. This case highlights that in patients with sepsis and cirrhosis, acutely worsening coagulation parameters, falling fibrinogen, and evolving purpuric or necrotic skin lesions should not be attributed to liver disease alone but should instead prompt urgent evaluation for DIC and PF. The early recognition of this distinction is essential to guide timely multidisciplinary intervention in this rare but devastating complication.

CureusVol. 18(4)
Louisiana State University Health Sciences Center New Orleans (US), University of Louisiana at Lafayette (US)
Good health and well-being
Openalex Percentile: Top 35%
Sepsis Diagnosis and Treatment
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