Korean J Anesthesiol.  2021 Jun;74(3):266-270. 10.4097/kja.20201.

Refractory gram-negative septic shock complicated by extended purpura fulminans and multiple organ failure in a 23-year-old puerpera -a case report-

  • 1Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-sultan, Kazakhstan
  • 2Department of Anesthesiology and Critical Care, National Research Oncology Center, Nur-sultan, Kazakhstan
  • 3Department of Anesthesiology, Astana Medical University, Nur-sultan, Kazakhstan
  • 4Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russian Federation


Pregnancy-related infections are the third most common cause of maternal death worldwideThe aim of this report is to present a case of pregnancy-related infection, which progressed into refractory septic shock accompanied by purpura fulminans and multiple organ failure. Case: A 23-year-old woman in the postpartum period developed fulminant, refractory septic shock complicated by purpura fulminans and multiple organ failure syndrome (acute respiratory distress syndrome, acute kidney injury, and encephalopathy). Management included antibacterial therapy, fluid and transfusion therapy, nutritional support, protective mechanical ventilation, hydrocortisone, a large dose of ascorbic acid, and thiamine. There were no neurological consequences and all organ functions returned to normal, although the predicted hospital mortality based on the Sequential Organ Failure Assessment (SOFA) score was more than 90%.
Septic shock is a significant, yet not completely understood life-threatening condition, which can be associated with purpura fulminans, multiple organ dysfunction, disseminated intravascular coagulation, and massive tissue necrosis.


Disseminated intravascular coagulation; Purpura fulminans; Sepsis; Septic shock; Tissue necrosis; Vasopressors
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