Evaluating the association between super-antigens and acute infectious purpura fulminans: a case report

Acute infectious purpura fulminans (AIPF) is a rare life-threatening disease that causes septic shock and disseminated intravascular coagulation, with localized purpura of the extremities. However, it has not been well documented. Herein, we describe the pathology of AIPF in relation to the presence of super-antigens. A 74-year-old woman was brought to the hospital with disturbed consciousness. Six hours after, the patient progressed into septic shock and developed localized purpura over the extremities. On the 4th day, the skin began to peel, which resulted in dry gangrene. Streptococcus pneumoniae was identified from blood cultures taken on the 5th day. Therefore, we diagnosed the patient with AIPF. However, despite providing intensive care, the patient died on the 16th day. Owing to the rapid onset of skin symptoms, we suspected the involvement of super-antigens in the pathogenesis of AIPF. On the basis of a previous report that suggested a relationship between super-antigens and AIPF, we evaluated the patient for the presence of such an association. However, we did not detect any super-antigens. There is a significant need for future studies to evaluate the association between super-antigens and AIPF, including screening for the presence of other super-antigens that were not measured in this study.