{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:06:48Z","timestamp":1782374808511,"version":"3.54.5"},"reference-count":17,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,9]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>\n                  <jats:italic>Haemophilus influenzae<\/jats:italic> typically causes illness and infection in the paediatric population. We report a case of a 53-year-old man who developed invasive non-typeable <jats:italic>H. influenzae<\/jats:italic> infection associated with purpura fulminans and multiorgan failure. On review of the literature, this is the first reported case of non-typeable <jats:italic>H. influenzae<\/jats:italic> causing purpura fulminans. The patient was treated with intravenous ceftriaxone 2\u2009g\/day and was eventually discharged from the hospital almost 2\u2009months after admission. We discuss the role that infection\/sepsis plays in disturbances to the coagulation cascade leading to purpura fulminans and the virulence factors that make non-typeable <jats:italic>H. influenzae<\/jats:italic> unique. Finally, we review other cases of <jats:italic>H. influenzae<\/jats:italic> associated with purpura fulminans and discuss the similarities with our case.<\/jats:p>","DOI":"10.1136\/bcr-2020-234880","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T02:15:24Z","timestamp":1594260924000},"page":"e234880","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Non-typeable <i>Haemophilus influenzae<\/i> and purpura fulminans"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1803-9520","authenticated-orcid":false,"given":"Vivek Bhika","family":"Beechar","sequence":"first","affiliation":[{"name":"Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"de la Flor","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J","family":"Medford","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"2025082723483726000_13.7.e234880.1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.53.4.471"},{"key":"2025082723483726000_13.7.e234880.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70734-0"},{"key":"2025082723483726000_13.7.e234880.3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/IPC.0000000000000485","article-title":"Purpura fulminans: a case report and review of all causes","volume":"25","author":"Shenoy","year":"2017","journal-title":"Infectious Diseases in Clinical Practice"},{"key":"2025082723483726000_13.7.e234880.4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr.09.2010.3368","article-title":"Austrian syndrome.","volume":"2011","author":"Poulsen","year":"2011","journal-title":"BMJ Case Rep"},{"key":"2025082723483726000_13.7.e234880.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.bcr.0000194269.95027.51"},{"key":"2025082723483726000_13.7.e234880.6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/2052-0492-2-13","article-title":"A case of purpura fulminans caused by Hemophilus influenzae complicated by reversible cardiomyopathy","volume":"2","author":"Endo","year":"2014","journal-title":"J Intensive Care"},{"key":"2025082723483726000_13.7.e234880.7","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir735"},{"key":"2025082723483726000_13.7.e234880.8","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1093\/cid\/ciy187","article-title":"Current epidemiology and trends in invasive Haemophilus influenzae Disease-United states, 2009-2015","volume":"67","author":"Soeters","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2025082723483726000_13.7.e234880.9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.2478\/v10153-011-0073-y","article-title":"Virulence factors and mechanisms of antibiotic resistance of Haemophilus influenzae","volume":"54","author":"Kostyanev","year":"2012","journal-title":"Folia Med"},{"key":"2025082723483726000_13.7.e234880.10","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2018.1484286"},{"key":"2025082723483726000_13.7.e234880.11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.tmrv.2017.10.001","article-title":"Purpura fulminans: mechanism and management of dysregulated hemostasis","volume":"32","author":"Colling","year":"2018","journal-title":"Transfus Med Rev"},{"key":"2025082723483726000_13.7.e234880.12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1160\/TH03-03-0182","article-title":"Coagulopathy of sepsis","volume":"91","author":"Dempfle","year":"2004","journal-title":"Thromb Haemost"},{"key":"2025082723483726000_13.7.e234880.13","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201302-0228OC"},{"key":"2025082723483726000_13.7.e234880.14","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.4.933-951.2001"},{"key":"2025082723483726000_13.7.e234880.15","unstructured":"Adverse drug reaction probability scale (Naranjo) in drug induced liver injury . 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