Key result
A 41-year-old male with purpura fulminans caused by Hemophilus influenzae developed reversible septic cardiomyopathy requiring ECMO, but ultimately died from sepsis caused by empyema on day 34.
Case Report (n=1)
V-A ECMO can provide effective early hemodynamic support for reversible septic cardiomyopathy complicating purpura fulminans, though overall mortality remains high due to infectious complications.
ECMO may support reversible septic cardiomyopathy in purpura fulminans; leaves open strategies to reduce infectious mortality.
Here, we report a case of a 41-year-old male diagnosed as septic shock with purpura fulminans (PF) infection. The causative organism was β-lactamase-negative ampicillin-resistant Hemophilus influenzae. He developed fulminant cardiac dysfunction approximately 1 h after admission, and the cause was considered to be septic cardiomyopathy. Blood pressure and oxygenation were maintained at adequate levels with the aid of extracorporeal membrane oxygenation (ECMO). The cardiac dysfunction was reversible, and he was successfully weaned from ECMO on day 12 of hospitalization. However, he needed amputation for all extremities because the infection spread to his limbs and eventually, succumbed to sepsis caused by empyema on day 34 of hospitalization. To the best of our knowledge, this is only the second case of PF caused by H. influenzae in an adult to be reported worldwide.
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Endo et al. (2014) conducted a case report in Purpura fulminans caused by Hemophilus influenzae complicated by reversible cardiomyopathy (n=1). Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and antibiotics was evaluated on Clinical outcome. A 41-year-old male with purpura fulminans caused by Hemophilus influenzae developed reversible septic cardiomyopathy requiring ECMO, but ultimately died from sepsis caused by empyema on day 34.
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