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Volume 49, Issue 5, Pages 489.e5-489.e9 (September 2010)


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Disseminated Intravascular Coagulation, Meningococcal Infection, and Ischemic Changes Affecting the Lower Extremities: A Case Study

Jessica L. Herzog, DPM1, Kenneth P. Morgan, DPM, FACFAS2, Matthew H. Paden, DPM, FACFAS3, Paul A. Stone, DPM, FACFAS4Corresponding Author Informationemail address

published online 12 July 2010.

Abstract 

A middle-aged woman presented from an outside hospital with a diagnosis of Neisseria meningitidis and meningococcemia. A nonpalpable purpuric skin rash evolved into multiple wounds, with gradual necrosis of bilateral lower and upper extremities. Throughout the course of hospitalization, the patient developed ventricular tachycardia, normocytic anemia, thrombocytosis, Clostridium difficile infection, depression, and transient right eye blindness. The finding of decreased CH50 in the complement cascade was considered as the potential cause of the meningococcemia. The subsequent ischemia and necrosis of extremities were attributed to the systemic effect and trauma ensuing from N. meningitidis.

Level of Clinical Evidence4

1 Submitted during 3rd year residency, Highlands Presbyterian/St. Luke’s Denver Podiatric Surgical Residency, Denver, CO

2 Attending physician, Highlands Presbyterian/St. Luke’s Denver Podiatric Surgical Residency, Denver, CO

3 Director of Residency Education, Highlands Presbyterian/St. Luke’s Denver Podiatric Surgical Residency, Denver, CO

4 Director of Research, Highlands Presbyterian/St. Luke’s Denver Podiatric Surgical Residency, Denver, CO

Corresponding Author InformationAddress correspondence to: Paul. A. Stone, DPM, 5375 South Florence Ct, Greenwood Village, CO 80111.

 Financial Disclosure: None reported.

 Conflict of Interest: None reported.

PII: S1067-2516(10)00128-6

doi:10.1053/j.jfas.2010.04.005


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