{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T00:21:03Z","timestamp":1723854063406},"reference-count":0,"publisher":"Sri Lanka Journals Online","issue":"3","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ceylon Med. J."],"abstract":"<jats:p>Background: Purpura fulminans (PF) is a term used to describe a heterogeneous group of disorders characterized by rapidly progressive purpuric lesions that develop into extensive areas of skin necrosis and peripheral gangrene [1]. Purpura fulminans is known to be associated with many infections, such as menin-gococcal, staphylococcal, and streptococcal infections. There are very few reports of this entity with spotted fever group rickettsioses and scrub typhus in Sri Lanka.Case presentation: A 33-year-old female with intellectual disability since childhood presented with an acute febrile illness for seven days. She also had severe arthralgia, conjunctival suffusion, and a widespread \u201cfern-leaf pattern\u201d necrotic skin rash involving both upper limbs and lower limbs, sparing the face and trunk. She had a very high antibody titer against Rickettsia Conorii antigen, confirming the diagnosis of SFG rickettsioses, and recovered completely with anti-rickettsial therapy.Conclusion: Clinicians should consider rickettsial infection as one of the differential diagnoses in a patient presenting with acute febrile illness with patchy necrotic skin lesions which would help in early diagnosis and initiating appropriate treatment, thus preventing a deleterious outcome.<\/jats:p>","DOI":"10.4038\/cmj.v68i3.9871","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T07:32:51Z","timestamp":1723793571000},"page":"148-151","source":"Crossref","is-referenced-by-count":0,"title":["Rare presentation of rickettsial infection as purpura fulminans"],"prefix":"10.4038","volume":"68","author":[{"given":"Melani Shobia","family":"Emmanuel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjan","family":"Premaratna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2473","published-online":{"date-parts":[[2024,8,16]]},"container-title":["Ceylon Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/account.cmj.sljol.info\/index.php\/sljo-j-cmj\/article\/download\/9871\/6888","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.cmj.sljol.info\/index.php\/sljo-j-cmj\/article\/download\/9871\/6888","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T07:32:55Z","timestamp":1723793575000},"score":1,"resource":{"primary":{"URL":"https:\/\/account.cmj.sljol.info\/index.php\/sljo-j-cmj\/article\/view\/9871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,8,16]]}},"URL":"https:\/\/doi.org\/10.4038\/cmj.v68i3.9871","relation":{},"ISSN":["2386-1274","0009-0875"],"issn-type":[{"value":"2386-1274","type":"electronic"},{"value":"0009-0875","type":"print"}],"subject":[],"published":{"date-parts":[[2024,8,16]]}}}