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British Journal of Anaesthesia, 2001, Vol. 86, No. 4 581-586
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Review of management of purpura fulminans and two case reports

J. Nolan and R. Sinclair

Department of Anaesthesia, Treliske Hospital, Truro, Cornwall TR1 3LJ, UK*Corresponding author: Department of Anaesthesia, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, UK

Purpura fulminans (PF) is a haemorrhagic condition usually associated with sepsis or previous infection. Features include tissue necrosis, small vessel thrombosis and disseminated intravascular coagulation. Gram-negative organisms are the commonest cause of the acute infectious type, which is often associated with multi-organ failure. An idiopathic variety, however, is often confined to the skin. The mortality rate has decreased with better treatment of secondary infections, supportive care and new treatments, but it remains a disabling condition often requiring major amputations. We describe two cases and review the various treatments for this condition.

Br J Anaesth 2001; 86: 581–6


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