The Internet Book of Critical Care Podcast IBCC Episode 111- Purpura Fulminans
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Feb 19, 2021 AI Snips
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Purpura Fulminans as Distinct Entity
- Purpura fulminans is a distinct thrombotic subtype of disseminated intravascular coagulation marked by profound microvascular thrombosis and skin necrosis.
- Recognizing it separately is crucial because it requires specific management distinct from general septic or toxic shock.
Identify Early Skin Signs
- Look for non-blanching violaceous skin patches on extremities that progress to black necrosis within 24-48 hours.
- Watch for adrenal gland thrombosis and renal failure as signs of systemic involvement.
Use Heparin Despite Resistance
- Anticoagulate purpura fulminans patients with heparin despite resistance due to coagulation derangement.
- Prefer increasing heparin dose over antithrombin supplementation unless guided by hematology.