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A rapidly spreading, painful rash and confusion developed in a 46-year-old male patient with a history of chronic alcoholism. On physical examination, he was febrile and hypotensive and had a purpuric rash (Panel A). Laboratory evaluation revealed disseminated intravascular coagulation, acute renal failure, and rhabdomyolysis. Capnocytophaga canimorsus was isolated from blood cultures and cerebrospinal fluid. His purpuric skin eruption displayed a netlike pattern referred to as retiform. Retiform purpura is an indication of an acute thrombotic vasculopathy. If acute and rapidly progressive in a febrile patient, it suggests purpura fulminans. In this patient, the thrombosed veins of the deep and . . . [Full Text of this Article] |
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