Open AccessSepsis‐associated purpura fulminans caused by emphysematous cystitis
Author(s) -
Fukuta Kyotaro,
Shiozaki Keito,
Nakanishi Ryoichi,
Inai Tohru,
Izaki Hirofumi,
Yamamura Rie,
Nakataki Emiko,
Kudo Eiji,
Kanda Kazuya
Publication year - 2021
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12359
Subject(s) - medicine , purpura fulminans , sepsis , septic shock , disseminated intravascular coagulation , surgery , shock (circulatory) , purpura (gastropod) , oliguria , renal function , ecology , biology
Emphysematous cystitis is a rare pathology characterized by gas bubbles within the bladder wall and lumen from gas‐producing bacteria. Sepsis‐associated purpura fulminans is also rare and shows poor clinical outcomes. Case presentation A 73‐year‐old man was hospitalized at a nearby hospital due to chronic subdural hematoma, symptomatic epilepsy, and diabetes mellitus. He was transferred to our hospital with fever, low blood pressure, and cyanosis of the legs, and was diagnosed with septic shock due to emphysematous cystitis with purpura fulminans. He underwent intensive treatment, including retroperitoneal drainage. Urine culture was positive for Citrobacter freundii . His general condition gradually improved and diffuse air decreased after surgery, but progressive purpuric skin necrosis became evident on the legs, which could not be salvaged. He died on the 25th hospital day. Conclusion Sepsis‐associated purpura fulminans caused by emphysematous cystitis shows a very poor prognosis irrespective of intensive treatment, including retroperitoneal drainage.