A Rare Case of Purpura Fulminans in the Setting of Klebsiella pneumoniae Bacteremia


North Florida


North Florida Regional Medical Center

Document Type

Case Report

Publication Date



critical care, klebsiella pneumoniae, disseminated intravascular coagulation, acute infectious purpura fulminans, purpura fulminans


Bacterial Infections and Mycoses | Hemic and Lymphatic Diseases | Internal Medicine


A 23-year-old man with circulatory shock associated with severe sepsis and congestive heart failure with an ejection fraction of 10% resulting in anasarca and multiorgan failure was admitted to our hospital's intensive care unit. Hours after admission, he developed a rash on his left inner thigh, which was later diagnosed as purpura fulminans (PF). Blood cultures were consistent with Klebsiella pneumoniae bacteremia, with community-acquired pneumonia being the possible source.

PF is a rare and difficult-to-diagnose entity characterized by dysregulated hemostasis that is often associated with poor prognosis and fatal outcomes. To our knowledge, there are limited reports in the literature on K. pneumoniae as a cause of PF. Given the rarity of this presentation, this case will serve as an opportunity to report and discuss the pathophysiology of this disease for the benefit of physicians.

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