Abstract
Acute infectious purpura fulminans (AIPF) is a life-threatening disease, characterized by a rapid progression of symmetric peripheral gangrene associated with severe infection and often requires urgent amputation or reconstructive surgery even for survivors. To the best of our knowledge, this is the first reported case of AIPF in a Crohn's disease (CD) patient. A 40-year-old female suffering from CD for more than 20 years was hospitalized due to obstruction of the ileum. Anti-tumor necrosis factor therapy was withdrawn 15 days before the surgical intervention. During the peri-operation period, paralytic ileus followed by severe sepsis occurred and she then presented the symptoms of AIPF in the hands and legs, which was caused by Citrobacter freundii infection. Given the immunocompromised and hypercoagulability condition of CD patients, daily medicine can result in such fatal complications and thus careful attention to the patient's immune factors is critical. A multidisciplinary team approach is also crucial to rescue the patient from AIFP.
