ro13-9904 and Purpura--Thrombotic-Thrombocytopenic

A 42-year-old woman with a history of acute myeloid leukaemia status postallogeneic stem cell transplant presented with fevers, altered mental status, pulmonary infiltrates and septic shock that further progressed to thrombocytopenia and purpura fulminans. Laboratory studies were consistent with a diagnosis of thrombotic thrombocytopenic purpura (TTP). Blood cultures grew

Topics: Adult; Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Diagnosis, Differential; Female; Fibrinolytic Agents; Fingers; Gangrene; Glucocorticoids; Graft vs Host Disease; Humans; Immunologic Factors; Leukemia, Myeloid, Acute; Nose; Plasma Exchange; Pneumococcal Infections; Purpura Fulminans; Purpura, Thrombotic Thrombocytopenic; Rituximab; Shock, Septic; Single-Domain Antibodies; Stem Cell Transplantation; Toes

Topics: ADAM Proteins; ADAMTS13 Protein; Anti-Bacterial Agents; Ceftriaxone; Diagnosis, Differential; Humans; Leptospirosis; Male; Middle Aged; Purpura, Thrombotic Thrombocytopenic

Topics: Borrelia burgdorferi Group; Ceftriaxone; Female; Humans; Lyme Disease; Middle Aged; Purpura, Thrombotic Thrombocytopenic

Although staphylococcal endocarditis has occasionally been associated with a TTP-like syndrome, a similar syndrome has not been reported with endocarditis due to aerobic gram-negative rods. We report a case of subacute bacterial endocarditis with a thrombocytopenic syndrome that at first resembled TTP which was due to an unusual gram-negative rod. This case emphasizes the need for repeated examination of the bacteremic patient to detect the changing murmurs of endocarditis.

Topics: Aged; Ceftriaxone; Endocarditis, Subacute Bacterial; Female; Gram-Negative Bacteria; Humans; Moraxella; Purpura, Thrombotic Thrombocytopenic