Work

Acral Purpura Fulminans With Erythrocyte-Associated Streptococcus pneumoniae: A Case Report

Year: 2025

Type: article

Abstract: A patient presented with acral purpura fulminans caused by Streptococcus pneumoniae septicemia. With antibiotics and intensive care, he survived but required amputations of both hands and feet due to ischemic necrosis. We observed diplococci adherent to erythrocytes on blood smear. This previously described phenomenon, named immune adherence, requires complement. Opsonized pneumococci bind to complement receptors on human erythrocytes. Circulating immune adherent pneumococci are delivered by erythrocytes to fixed splenic macrophages for bacterial killing. We hypothesize that defective reticuloendothelial function most likely contributed to our patient's overwhelming infection with septic syndrome, disseminated intravascular coagulation, and acral purpura fulminans.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2024.0854

Authors: Donald L. Granger, Jeannine Pembroke, Todd R. Gordon

Institutions: University of Utah, George E. Wahlen Department of VA Medical Center, United States Department of Veterans Affairs, Veterans Health Administration, VA Montana Health Care System

Language: English

Topic: Pneumonia and Respiratory Infections

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4407686318

FWCI:

Cites: 13

Cited by:

Related to: 10