Images in Clinical Medicine
Kim Eagle, M.D., Editor
Purpura Fulminans in Neisseria meningitidis Sepsis
N Engl J Med 1996; 334:1709June 27, 1996
- Article
Figure 1 A 26-year-old man with a one-day history of mild headache and fever was admitted to the hospital after having a seizure at home. He had had no contact with other sick people. On admission the patient's consciousness was impaired (score on the Glasgow coma scale, 10), but he had no neck stiffness. He was febrile (temperature, 41°C), with hypotension, leukopenia, and thrombocytopenia. Shortly after admission he had another seizure. The cerebrospinal fluid contained 165 red cells and 18 white cells per cubic millimeter, with 60 percent neutrophils, 5 percent band forms, 29 percent lymphocytes, and 6 percent monocytes. A Gram's stain showed no organisms, and antigen tests of the cerebrospinal fluid for Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meni ngitidis, and S. agalactiae (group B streptococci) were negative. The patient was intubated and treated with intravenous fluids and ceftriaxone.
Kim Eagle, M.D.
Luis M. de la Maza, M.D., Ph.D.
Marie Pezzlo, M.A.
University of California, Irvine, Orange, CA 92668-4805
