Septic Shock with Purpura in Children: an experimental and clinical approach

Septic shock with purpura is a rapidly evolving clinical picture characterized by sepsis (tachycardia, tachypnea, fever), shock (hypotension or signs of end-organ failure) and a spectrum of coagulation disorders (ranging from petechiae, purpura to ecchymoses). It is mainly (80 %) caused by N. meningitidis (group A, B or C). However, occasionally other micro-organisms such as Haemophilus influenzae, Haemophilus aegyptius, Streptococcus group A, group B streptococcus, streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas species and Capnocytophagus canimorsus can be detected as a causative agent. Even viruses can under certain conditions cause a comparable clinical picture. Approximately 80 % of the patients is below the age of 18 years, and 50 % below the age of 5 years. The development of the disease in older patients is partly due to the presence of a deficiency in the immune system (complement deficiency, spleen extirpation, diabetes mellitus). The occurrence in children is related to the absence of antibodies, although it is assumed that these children are healthy except for an agerelated immaturity oftheir immune system. The mortality ranges from 15 - 40 %, depending on the selection of the patients.

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