Purpura Fulminans in Meningococcemia: Association with Acquired Deficiencies of Proteins C and S

To the Editor: The current outbreak of Neisseria meningitidis (predominantly type C) infection among children in the greater Los Angeles area (128 cases with 27 deaths, including 29 bacteriologically proved cases with 5 deaths at the Los Angeles County–University of Southern California Medical Center) has been associated with a high incidence of purpura fulminans. This syndrome of dermal microvascular thrombosis with hemorrhagic necrosis may lead to gangrene and autoamputation of distal extremities, and is particularly likely to complicate meningococcemia in infants and young children. The lipopolysaccharide meningococcal endotoxin has been shown to be a potent inducer of the dermal Shwartzman…, No extract is available for articles shorter than 400 words.