Purpura fulminans (PF) is a rare skin disorder with extensive areas of blueblack hemorrhagic necrosis. Patients manifest typical laboratory\r\nsigns of disseminated intravascular coagulation (DIC). Our case describes a 37-year-old previously healthy man who presented\r\nwith 3 days of generalized malaise, headache, vomiting, photophobia, and an ecchymotic skin rash. Initial laboratory\r\nworkup revealed DIC without obvious infectious trigger including unremarkable cerebrospinal fluid (CSF) biochemical analysis.\r\nThere was further progression of the skin ecchymosis and multiorgan damage consistent with PF. Final CSF cultures revealed\r\nStreptococcus pneumoniae. Despite normal initial CSF biochemical analysis, bacterial meningitis should always be considered in patients\r\nwith otherwise unexplained DIC as this may be an early manifestation of infection. PF is a clinical diagnosis that requires\r\nearly recognition and prompt empirical treatment, especially, in patients with progressive altered mental status, ecchymotic skin\r\nrash, and DIC.
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