{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:13:44Z","timestamp":1760109224396,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The patient was a man in his 80s who had undergone laparoscopic anterior resection for rectal cancer. Bowel obstruction occurred on the third postoperative day but improved with a decompression tube by the fifth postoperative day. A high fever (in the 38 \u00b0C range) was also observed. Blood culture tests detected two sets of the gram-negative bacilli Klebsiella aerogenes within 24 h of collection. On the seventh postoperative day, the patient subsequently went into septic shock with disseminated intravascular coagulation (DIC). On the eighth postoperative day, the fingertips and toes became black, and the palms and dorsal surfaces of both feet were dark purple due to peripheral circulatory failure. This suggested acute infectious purpura associated with sepsis (acute infectious purpura fulminans (AIPF)). Intensive care was provided; however, the necrosis of both middle fingers worsened, both middle fingers were gangrenous, and the patient died on the thirtieth postoperative day. AIPF is rarely reported, especially in early-onset cases after elective surgery. We encountered a rare complication of bacterial translocation from postoperative bowel obstruction, leading to AIPF.<\/jats:p>","DOI":"10.3390\/medicina60040644","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T09:15:20Z","timestamp":1713345320000},"page":"644","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Infectious Purpura Fulminans Complicated by Bacterial Translocation after Rectal Cancer Surgery: A Case Report"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-2456","authenticated-orcid":false,"given":"Ryo","family":"Nakanishi","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9318-3181","authenticated-orcid":false,"given":"Heita","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyuki","family":"Toyota","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minori","family":"Mise","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritsuto","family":"Akutsu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"ref_1","first-page":"25","article-title":"Note sur trios cas de purpura infectieux foudroyant","volume":"8","author":"Guelliot","year":"1884","journal-title":"Un Med. 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Antimicrob., 17.","DOI":"10.1186\/s12941-018-0282-9"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.12659\/AJCR.889352","article-title":"Neonatal purpura fulminans manifestation in early-onset group B streptococcal infection","volume":"14","author":"AlBarrak","year":"2013","journal-title":"Am. J. Case Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1086\/428573","article-title":"Purpura Fulminans Due to Staphylococcus aureus","volume":"40","author":"Kravitz","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","first-page":"2514","article-title":"Enterobacteriaceae","volume":"Volume 2","author":"Bennett","year":"2014","journal-title":"Principles and Practice of Infectious Diseases"},{"key":"ref_8","first-page":"945","article-title":"Nutritional Management for Bacterial Translocation During Ileus","volume":"19","author":"Higashiguchi","year":"1999","journal-title":"J. Abdom. Emerg. 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Gastroenterol."},{"key":"ref_15","first-page":"643","article-title":"Effectiveness and Usefulness of Polymyxin-B Direct Hemoperfusion (PMX-DHP) for Septic Shock","volume":"38","author":"Tokumitsu","year":"2018","journal-title":"J. Abdom. Emerg. 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