{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:04:27Z","timestamp":1787169867501,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Purpura fulminans (PF) is a potentially fatal disease characterized by rapidly progressive purpura that evolves into cutaneous necrosis and gangrene.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>This was an observational, retrospective study based on the review of case records of children with PF at a tertiary care children\u2019s hospital in Karnataka.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-two cases seen over a period of four years were included. The age of the study population ranged from 11 days to 13 years (mean age: 4.21 years) and a male to female ratio of 1:1.2. Fever with purpura (86.3%) was the most common presenting symptom followed by swelling of the face and limbs (27.2%), altered sensorium (27.2%), convulsions (22.7%), abdominal distension (4.5%), respiratory distress (4.5%), myalgia (4.5%), and jaundice (4.5%). Cutaneous features included reticulate purpura (100%), necrosis (45.4%), ulcers (18.2%), maculopapular lesions (9.1%), and bullae (9.1%). Peripheral gangrene developed in eight children ( 36.3%). Lower limbs (90.9%) and upper limbs (86.3%) were the most common sites of involvement. The common causes were rickettsial fever (63.6%),\n                      <jats:italic toggle=\"yes\">Moraxella<\/jats:italic>\n                      (4.5%),\n                      <jats:italic toggle=\"yes\">Leptospira<\/jats:italic>\n                      (4.5%), multisystem inflammatory syndrome in children (4.5%), co-infections with\n                      <jats:italic toggle=\"yes\">Klebsiell<\/jats:italic>\n                      a and\n                      <jats:italic toggle=\"yes\">Acinetobacte<\/jats:italic>\n                      r (4.5%),\n                      <jats:italic toggle=\"yes\">Klebsiell<\/jats:italic>\n                      a and\n                      <jats:italic toggle=\"yes\">Citrobacte<\/jats:italic>\n                      r (4.5%), rickettsial fever with multisystem inflammatory syndrome (4.5%) and protein C deficiency (4.5%). The mortality rate was 4.5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>The retrospective nature of the study and the single-institution cohort were the limitations of this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Rickettsial infection was the most common etiology, while reticulate purpura, necrosis, and ulcers were the commonly seen cutaneous features of PF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/idoj.idoj_908_24","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T13:00:25Z","timestamp":1771592425000},"page":"225-228","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinico-Etiological Study of Purpura Fulminans: Experience from a Tertiary-Care Children Hospital"],"prefix":"10.4103","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5472-5654","authenticated-orcid":false,"given":"Shaziya","family":"Kalam","sequence":"first","affiliation":[{"name":"Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4356-2535","authenticated-orcid":false,"given":"Sahana M.","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. L.","family":"Keshavamurthy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. V.","family":"Basavaraja","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragalatha","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"R1-20260303","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/0002-9343(76)90339-9","article-title":"Purpura fulminans","volume":"61","author":"Spicer","year":"1976","journal-title":"Am J Med"},{"key":"R3-20260303","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1097\/MPH.0000000000001150","article-title":"Acquired versus congenital neonatal purpura fulminans: A case report and literature 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