Purpura fulminans associated with Streptococcus pneumoniae infection in a child.

Abstract

Neisseria meningitidis is the most frequent isolate associated with purpura fulminans in children. Although Streptococcus pneumoniae infection has been associated with purpura fulminans, with the exception of one adult, it has only been reported in immunocompromised hosts. We report an apparently previously healthy child who presented with purpura fulminans associated with pneumococcal meningitis. Case report and review of the medical literature from September 1966 to June 1997, using a MEDLINE search. While systemic pneumococcal infection is common in childhood, progression to purpura fulminans does not typically occur in overtly healthy children. Our patient illustrates that invasive pneumococcal infection should be considered and empirically treated in a child who presents with purpura fulminans, even in the absence of preexisting functional or anatomic asplenia.