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

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 Evidence: 4

Keywords: disseminated intravascular coagulation, complement deficiency, purpura fulminans