Meningococcal purpura fulminans treated with medicinal leeches

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dc.contributor.authorDippenaar R.
dc.contributor.authorSmith J.
dc.contributor.authorGoussard P.
dc.contributor.authorWalters E.
dc.date.accessioned2011-05-15T16:17:36Z
dc.date.available2011-05-15T16:17:36Z
dc.date.issued2006
dc.description.abstractINTRODUCTION: Meningococcal septicemia remains one of the most common infectious causes of admission to a pediatric intensive care unit. Numerous treatment strategies aimed at the thromboembolic complications inducing purpura fulminans and limb/digital ischemia have been attempted, with variable results. The successful use of medicinal leeches for pneumococcal purpura fulminans has been described, and we present a similar case of meningococcal purpura fulminans. PATIENT AND INTERVENTION: A 5-wk-old female infant with meningococcal meningitis and septicemia and progressive purpura fulminans of the left hand was treated with medicinal leeches. Medicinal leeches were applied to the left dorsal hand on a daily basis for 4 consecutive days. RESULT: The swelling and limited functionality visibly improved after 48 hrs, and by 120 hrs, perfusion in the distal phalanges of the thumb and middle finger was evident. Reperfusion of the distal phalanges was not fully sustained, and at 6 wks the plastic surgery department debrided the distal phalanges of her left hand, excluding the thumb. She fully recovered from the meningococcal septicemic shock; the functionality of her left thumb was preserved, and she has limited functionality of her left hand. CONCLUSION: The unique combination of salivary products in leech therapy has theoretical benefits and requires future study. Copyright © 2006 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
dc.description.versionArticle
dc.identifier.citationPediatric Critical Care Medicine
dc.identifier.citation7
dc.identifier.citation5
dc.identifier.issn15297535
dc.identifier.other10.1097/01.PCC.0000235422.23812.B4
dc.identifier.urihttp://hdl.handle.net/10019.1/14289
dc.subjectarticle
dc.subjectcase report
dc.subjectclinical feature
dc.subjectconvalescence
dc.subjectdebridement
dc.subjectepidemic meningitis
dc.subjectfemale
dc.subjectfinger
dc.subjectfulminating purpura
dc.subjectfunctional assessment
dc.subjecthand
dc.subjecthospital admission
dc.subjecthuman
dc.subjectinfant
dc.subjectintensive care unit
dc.subjectleeching
dc.subjectlimb ischemia
dc.subjectNeisseria meningitidis
dc.subjectnonhuman
dc.subjectperfusion
dc.subjectphalanx
dc.subjectpriority journal
dc.subjectsepticemia
dc.subjectthromboembolism
dc.subjectthumb
dc.subjecttreatment indication
dc.subjecttreatment outcome
dc.subjectBacteremia
dc.subjectFemale
dc.subjectFingers
dc.subjectGangrene
dc.subjectHumans
dc.subjectInfant
dc.subjectLeeching
dc.subjectMeningitis, Meningococcal
dc.subjectMeningococcal Infections
dc.subjectPurpura, Schoenlein-Henoch
dc.titleMeningococcal purpura fulminans treated with medicinal leeches
dc.typeArticle
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