Multiple amputations secondary to purpura fulminans in a young adult: a perspective in rehabilitation
DOI:
https://doi.org/10.28957/rcmfr.v29n1a5Keywords:
meningococcemia, purpura fulminans, amputation, prosthesis, rehabilitation.Abstract
Neisseria meningitidis‘infection is a frequent cause of meningitis and septicemia in people with risk factors; it has serious complications like the purpura fulminans, that is an uncommon and devastating pathology that begins with the appearance of purpuric lesions on the skin and that, finally produces important vascular compromise developing deep tissue necrosis that leads to amputations. We report the case of a young adult, male, member of the military force, in whom meningococcal infection is confirmed, presenting meningococcemia without meningitis. He develops purpura fulminans and finally, after hemodynamic stabilization, requires multiple secondary amputations: bilateral transtibial and in phalanges of the left hand. Afterhospitalization, the rehabilitation process begins and 9 months later he achieves ambulation with prosthesis in lower limbs.
References
1. Leite de Souza A, Sztajnboc J et al.. Short report: Severe myalgia of lower extremities as the first clinical feature of meningococcal purpura fulminans. Am J Trop Med Hyg. 2007;77:723-26.
2. Warner PM, Kagan RJ, Yakuboff KP et al. Current management of purpura fulminans: A multicenter study. J Burn Care Rehab. 2003;24:119-26. DOI: 10.1097/01.BCR.0000066789.79129.C2
3. Vélez-van-Meerbeke A, Medina-Silva N, Besada-Lombana S, Mojica-Madero JA. Epidemiología de la enfermedad por meningococo en Colombia. Infectio. 2016;2(4):1-7.
4. Bollero D, Stella M, Gangemi EN, Spaziante L, Nuzzo J, Sigaudo G, Enrichens F. Purpura fulminans in meningococcal septicaemia in an adult: a case report. Ann Burns Fire Disasters. 2010 Mar;23(1):43-7.
5. Caugant DA, Maiden MC. Meningococcal carriage and disease population biology and evolution. Vaccine. 2009;27(Suppl 2):B64-70. DOI: 10.1016/j.vaccine.2009.04.061
6. Campsall P A, Laupland K B, Niven D J. Severe meningococcal infection: a review of epidemiology, diagnosis, and management. Crit Care Clin. 2013;29(3): 393-409. DOI: 10.1016/j.ccc.2013.03.001
7. Bidmos FA, Neal KR, Oldfield NJ, et al. Persistence, replacement, and rapid clonal expansion of meningococcal carriage isolates in a 2008 university student cohort. J Clin Microbiol. 2011;49:506-12. DOI: 10.1128/JCM.01322-10
8. Broderick MP, Faix DJ, Hansen CJ, et al. Trends in meningococcal disease in the United States military, 1971-2010. Emerg Infect Dis. 2012;18:1430-7. DOI: 10.3201/eid1809.120257
9. HCFA Common Procedure Coding System HCPCS 2001. Washington (DC): US Government Printing Of?ce; 2001. ch 5.3. 10. Meningococcemia, First consult in https://www-clinicalkeyes.ezproxy.umng.edu.co/#!/content/medical_topic/21-s2.0-20111.Rewiew on March. 2018.
11. Ochoa-Díaz AF, Sánchez-Pardo S. Meningococcemia sin meningitis en adulto joven inmunocompetente: reporte de caso. Duazary. 2018 mayo;15(2):211. DOI: http://dx.doi.org/10.21676/2389783X.2106
12. Meier III R, Melton D. Ideal Functional Outcomes for Amputation Levels. Phys Med Rehabil Clin N Am. 2014;25:199-212. DOI: 10.1016/j.pmr.2013.09.011
13. Gutiérrez, M. (2016). Rehabilitación del paciente amputado. In: F. Ortiz, M. Rincón and J. Mendoza, ed., Texto de medicina física y rehabilitación, 1st ed. Bogotá D. C.: Manual moderno, pp. 426-41.
14. Bella JM, Margery AL. Prostetics & orthotics in clinical practice: a case study approach, 1st ed. Philadelphia, The F. A. Davis Company, 2011.
15. Gailey RS, Roach KE, Applegate B et al. The Amputee Mobility Predictor: An Instrument to Assess Determinants of the Lower-Limb Amputee’s Ability to Ambulate. Arch Phys Med Rehabil. 2002 May;83(5):613-27. DOI: https://doi.org/10.1053/apmr.2002.32309
16. Heinermann AW, Connelly L, Ehrlich-Jones Linda, Fatone S. Outcome Instruments for Prosthetics: Clinical Applications. Phys Med Rehabil Clin N Am. 2014:25:179-98. DOI:10.1016/j.pmr.2013.09.002
17. Tiffin J, Asher EJ. The Purdue Pegboard: Norms and Studies of Reliability and Validity. Journal of Applied Psicology. 1948;32:234-24.
2. Warner PM, Kagan RJ, Yakuboff KP et al. Current management of purpura fulminans: A multicenter study. J Burn Care Rehab. 2003;24:119-26. DOI: 10.1097/01.BCR.0000066789.79129.C2
3. Vélez-van-Meerbeke A, Medina-Silva N, Besada-Lombana S, Mojica-Madero JA. Epidemiología de la enfermedad por meningococo en Colombia. Infectio. 2016;2(4):1-7.
4. Bollero D, Stella M, Gangemi EN, Spaziante L, Nuzzo J, Sigaudo G, Enrichens F. Purpura fulminans in meningococcal septicaemia in an adult: a case report. Ann Burns Fire Disasters. 2010 Mar;23(1):43-7.
5. Caugant DA, Maiden MC. Meningococcal carriage and disease population biology and evolution. Vaccine. 2009;27(Suppl 2):B64-70. DOI: 10.1016/j.vaccine.2009.04.061
6. Campsall P A, Laupland K B, Niven D J. Severe meningococcal infection: a review of epidemiology, diagnosis, and management. Crit Care Clin. 2013;29(3): 393-409. DOI: 10.1016/j.ccc.2013.03.001
7. Bidmos FA, Neal KR, Oldfield NJ, et al. Persistence, replacement, and rapid clonal expansion of meningococcal carriage isolates in a 2008 university student cohort. J Clin Microbiol. 2011;49:506-12. DOI: 10.1128/JCM.01322-10
8. Broderick MP, Faix DJ, Hansen CJ, et al. Trends in meningococcal disease in the United States military, 1971-2010. Emerg Infect Dis. 2012;18:1430-7. DOI: 10.3201/eid1809.120257
9. HCFA Common Procedure Coding System HCPCS 2001. Washington (DC): US Government Printing Of?ce; 2001. ch 5.3. 10. Meningococcemia, First consult in https://www-clinicalkeyes.ezproxy.umng.edu.co/#!/content/medical_topic/21-s2.0-20111.Rewiew on March. 2018.
11. Ochoa-Díaz AF, Sánchez-Pardo S. Meningococcemia sin meningitis en adulto joven inmunocompetente: reporte de caso. Duazary. 2018 mayo;15(2):211. DOI: http://dx.doi.org/10.21676/2389783X.2106
12. Meier III R, Melton D. Ideal Functional Outcomes for Amputation Levels. Phys Med Rehabil Clin N Am. 2014;25:199-212. DOI: 10.1016/j.pmr.2013.09.011
13. Gutiérrez, M. (2016). Rehabilitación del paciente amputado. In: F. Ortiz, M. Rincón and J. Mendoza, ed., Texto de medicina física y rehabilitación, 1st ed. Bogotá D. C.: Manual moderno, pp. 426-41.
14. Bella JM, Margery AL. Prostetics & orthotics in clinical practice: a case study approach, 1st ed. Philadelphia, The F. A. Davis Company, 2011.
15. Gailey RS, Roach KE, Applegate B et al. The Amputee Mobility Predictor: An Instrument to Assess Determinants of the Lower-Limb Amputee’s Ability to Ambulate. Arch Phys Med Rehabil. 2002 May;83(5):613-27. DOI: https://doi.org/10.1053/apmr.2002.32309
16. Heinermann AW, Connelly L, Ehrlich-Jones Linda, Fatone S. Outcome Instruments for Prosthetics: Clinical Applications. Phys Med Rehabil Clin N Am. 2014:25:179-98. DOI:10.1016/j.pmr.2013.09.002
17. Tiffin J, Asher EJ. The Purdue Pegboard: Norms and Studies of Reliability and Validity. Journal of Applied Psicology. 1948;32:234-24.
How to Cite
1.
Gutiérrez M Ángel, Acevedo González JA. Multiple amputations secondary to purpura fulminans in a young adult: a perspective in rehabilitation. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2019 Sep. 4 [cited 2024 May 18];29(1):56-64. Available from: https://revistacmfr.org/index.php/rcmfr/article/view/228
Downloads
Download data is not yet available.
Downloads
Published
2019-09-04
Issue
Section
Clinical cases
