Purpura Fulminans in an Extremely Premature Infant: A Case Report.

Neonatal purpura fulminans is a rare and challenging diagnosis due to its resemblance to other necrotizing skin conditions and the immature coagulation system in newborns. Early multidisciplinary intervention is key. We present the case of an extremely premature infant, born at 24 + 3 weeks' ge...

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Detalhes bibliográficos
Autores: Roig AR, de Oliveira ECF, Borràs-Novell C, Martínez AÁ, Gimenez AE, Serrano MB, Acevedo GP, Gracia C, Cortada ÀP, Casanova MA
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p29536
Acesso em linha:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29536
Access Level:acceso abierto
Palavra-chave:blood coagulation disorders
case report
premature infant
prematurity
purpura fulminans
Descrição
Resumo:Neonatal purpura fulminans is a rare and challenging diagnosis due to its resemblance to other necrotizing skin conditions and the immature coagulation system in newborns. Early multidisciplinary intervention is key. We present the case of an extremely premature infant, born at 24 + 3 weeks' gestation and weighing 520 g. Clinical evolution, diagnostic approach, and therapeutic strategies are described. By day 5, the infant developed hemorrhagic-necrotic skin lesions. Diagnosis of purpura fulminans led to broad-spectrum antibiotics, anticoagulation, supportive care, and surgery. Despite complications such as osteomyelitis and scarring, the patient's condition improved. Genetic testing ruled out congenital protein C/S deficiency, suggesting an infectious etiology. Therapeutic decisions were guided by ethical considerations, prioritizing family-centered care and patient comfort. This case adds to the limited literature on purpura fulminans in preterm infants and, to our knowledge, represents the smallest patient reported to date.