Purpura Fulminans in an Extremely Premature Infant: A Case Report
Por:
Roig AR, de Oliveira ECF, Borràs-Novell C, Adame A, Espinosa A, Miguel Bejarano Serrano, Pérez-Acevedo G, Gracia C, Pertierra-Cortada A and Alsina-Casanova M
Publicada:
15 nov 2025
Ahead of Print:
15 nov 2025
Resumen:
Highlights What are the main findings? Purpura fulminans can occur in extremely premature infants, although rarely described. Early recognition and aggressive multidisciplinary treatment are essential for survival. What is the implication of the main finding? Ethical decision-making and family-centered care are key throughout the clinical course.Highlights What are the main findings? Purpura fulminans can occur in extremely premature infants, although rarely described. Early recognition and aggressive multidisciplinary treatment are essential for survival. What is the implication of the main finding? Ethical decision-making and family-centered care are key throughout the clinical course.Abstract 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.
Filiaciones:
Roig AR:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, 08028 Barcelona, Spain
de Oliveira ECF:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, 08028 Barcelona, Spain
Borràs-Novell C:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, 08028 Barcelona, Spain
Adame A:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, 08950 Barcelona, Spain
Espinosa A:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, 08950 Barcelona, Spain
Miguel Bejarano Serrano:
Pediatric Surgery Department, Hospital Sant Joan de Déu, Universitat de Barcelona, 08950 Barcelona, Spain
Pérez-Acevedo G:
Pediatric Nurse, Hospital Sant Joan de Déu, Universitat de Barcelona, 08950 Barcelona, Spain
Gracia C:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, 08028 Barcelona, Spain
Pertierra-Cortada A:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Sant Joan de Déu, Universitat de Barcelona, 08950 Barcelona, Spain
Alsina-Casanova M:
Neonatology Department, BCNatal-Centre de Medicina Maternofetal i Neonatologia de Barcelona, Hospital Clínic, Universitat de Barcelona, 08028 Barcelona, Spain
Green Submitted, gold
|