Purpura fulminans on the nose with septic abortion

Excerpt

A 39-year-old female presented with shock with a purple nose. She had been admitted in another hospital for management of an incompetent internal orifice of the cervix and had undergone a McDonald operation at 19 weeks of gestational age. Two weeks later, she had a fever, and ultrasonographic evaluation revealed intrauterine fetal death. The dead fetus was delivered with oxytocin, and the patient immediately went into shock. At that time, there was an abrupt skin color change to purple only on the nose. Under the impression of septic abortion, broad-spectrum antibiotics were administered. Laboratory findings showed disseminated intravascular coagulation (DIC). Renal dysfunction ensued so continuous renal replacement therapy was started. Two days later, Escherichia coli was identified from the blood and vaginal discharge cultures. After 7 days of intensive care, she had completely recovered from the septic shock. The purple nose was diagnosed as purpura fulminans (PF) and treated with prostaglandin E1. Then it returned to normal. …