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Case Reports:
J. Nolan and R. Sinclair
Review of management of purpura fulminans and two case reports
Br. J. Anaesth. 2001; 86: 581-586 [Abstract] [Full text] [PDF]
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[Read E-letter] First-hand experience
Judy Otteson   (28 August 2007)

First-hand experience 28 August 2007
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Judy Otteson,
trauma counselor (24 yrs.)

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Re: First-hand experience

Thank you for putting this article online.

In November 2004, I suffered a tiny dog bite on my right hand and, 72 hours later, was ill with flu-like symptoms and purple mottling that I thought were bruises. Friends drove me to an emergency room, where I was soon intubated and thence ambulanced to a larger intensive care unit in my town. Given a 5-10% chance of survival, and already septic, I developed severe sepsis with multi-organ failure, Acute Respiratory Distress Disorder (ARDS), Disseminated Intravascular Coagulopathy (DIC) , and Purpura Fulminans waist-down -- as well as on both arms. At day 18, I was airlifted to Harborview Medical Center in Seattle with extensive lower- limb necrosis and gangrene in my right hand and both feet. Necrotic soft- tissue was excised from knees to ankles of both legs, as well as from a huge wound on my inner right thigh. Excision, skin harvesting (from back), grafting, as well as bilateral transmetatarsal amputations (TMAs) and (four) right digits, were performed by Matthew B. Klein, M.D., at the Harborview Burn Unit.

A year after the incident, revision was one on my left foot, with removal of another 1", thus making it identical to the right in size.

Today I am ambulatory, type 65 wpm using my thumb, have returned to playing the piano, and ride horses. I look forward to a right hip replacement in the next 3-6 months, due to DJD probably exacerbated by my first year of irregular gait.

Your article adds details to my rather extensive research of what happened to me. Thanks for letting me read it.

JUDY OTTESON Yakima, Washington USA

Conflict of Interest:

None declared