Sign in Subscribe
Communicable diseases

Rare Complication of Bariatric Surgery: Purpura Fulminans Due to Streptococcus Pneumoniae Sepsis

Strategic Insights

— 1 min read

A rare case of purpura fulminans has been reported in an older female patient who underwent bariatric surgery and developed Streptococcus pneumoniae sepsis following gastric bypass. The patient's symptoms, including deep venous thrombosis, pulmonary embolus, and disseminated intravascular coagulation, led to a diagnosis of purpura fulminans, a condition characterized by the rapid destruction of platelets and clotting factors. Treatment with ceftriaxone and drotrecogin alfa, along with parenteral nutrition, led to the disappearance of the pathogen and normalization of the anticoagulant factors.

Key Takeaways:

  • A 55-year-old female patient developed purpura fulminans due to Streptococcus pneumoniae sepsis following gastric bypass surgery.
  • The patient's symptoms included deep venous thrombosis, pulmonary embolus, and disseminated intravascular coagulation.
  • The diagnosis was made based on laboratory evidence of disseminated intravascular coagulation and marked depletion of proteins C and S, as well as antithrombin.
  • Treatment with ceftriaxone and drotrecogin alfa, along with parenteral nutrition, led to the disappearance of the pathogen and normalization of the anticoagulant factors.
  • Malabsorption of vitamin K-dependent proteins C, S, and antithrombin due to bariatric surgery is believed to have predisposed the patient to purpura fulminans and disseminated intravascular coagulation.
  • The case highlights the importance of monitoring patients for signs of complications following bariatric surgery.
  • Lawrence A. Cone and colleagues published their study in Obesity Surgery (Purpura fulminans due to Streptococcus pneumoniae sepsis following gastric bypass. Obes Surg, 2004;14(5):690-694).

Statistics:

  • 55-year-old female patient developed purpura fulminans due to Streptococcus pneumoniae sepsis following gastric bypass surgery.
  • Patient's symptoms included:

+ Deep venous thrombosis

+ Pulmonary embolus

+ Disseminated intravascular coagulation

  • Laboratory evidence showed:

+ Disseminated intravascular coagulation

+ Marked depletion of proteins C and S

+ Depletion of antithrombin

  • Treatment resulted in:

+ Disappearance of the pathogen

+ Normalization of the anticoagulant factors

  • The case highlights the importance of monitoring patients for signs of complications following bariatric surgery.

Sources:

  • Cone, L. A., et al. (2004). Purpura fulminans due to Streptococcus pneumoniae sepsis following gastric bypass. Obes Surg, 14(5), 690-694.
  • Eisenhower Medical Center, Department of Medicine, Infectious Diseases Section, 39000 Bob Hope Drive, P 308, Rancho Mirage, CA 92270, USA.
  • FD-Communications Inc., 3100 Bayview Avenue, Unit 4, Toronto, Ontario M2N 5L3, Canada.

Read more