2017 Volume 66 Issue 6 Pages 726-730
A 53-year-old healthy male presented with slight fever and right chest pain. Three days later, his limbs felt cold and he had arthralgia. He was admitted to our hospital when he was judged to be in a severe state at his local hospital owing to a weak radial arterial pulse. He had systemic cyanosis, and pneumonia was detected by X-ray examination. A rapid urinary detection kit for Streptococcus pneumoniae showed a positive result. Accordingly, he was diagnosed as having acute infectious purpura fulminans (AIPF) caused by pneumococcal pneumonia. He recovered from sepsis and DIC because of early diagnosis and appropriate treatment. Therefore, we were able to save him. However, the purpura became worse without showing any improvement, and soon after, blisters formed, which progressed to skin peeling and dry necrosis on his extremities. Although he underwent debridement surgery for the necrotic tissues several times, he had his limbs amputated except the left arm. This is a rare case of fulminant pneumonia caused by S. pneumoniae in a healthy male. It was a case in which close collaboration with a clinic is very important while keeping in mind that there is a possibility of developing severe pneumococcus infection even in the absence of immunodeficiency such as splenectomy.
