Document Detail


Meningococcal purpura fulminans treated with medicinal leeches.
MedLine Citation:
PMID:  16878049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Meningococcal septicemia remains one of the most common infectious causes of admission to a pediatric intensive care unit. Numerous treatment strategies aimed at the thromboembolic complications inducing purpura fulminans and limb/digital ischemia have been attempted, with variable results. The successful use of medicinal leeches for pneumococcal purpura fulminans has been described, and we present a similar case of meningococcal purpura fulminans.
PATIENT AND INTERVENTION: A 5-wk-old female infant with meningococcal meningitis and septicemia and progressive purpura fulminans of the left hand was treated with medicinal leeches. Medicinal leeches were applied to the left dorsal hand on a daily basis for 4 consecutive days.
RESULT: The swelling and limited functionality visibly improved after 48 hrs, and by 120 hrs, perfusion in the distal phalanges of the thumb and middle finger was evident. Reperfusion of the distal phalanges was not fully sustained, and at 6 wks the plastic surgery department debrided the distal phalanges of her left hand, excluding the thumb. She fully recovered from the meningococcal septicemic shock; the functionality of her left thumb was preserved, and she has limited functionality of her left hand.
CONCLUSION: The unique combination of salivary products in leech therapy has theoretical benefits and requires future study.
Authors:
Ricky Dippenaar; Johan Smith; Pierre Goussard; Elisabetta Walters
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  7     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-08     Completed Date:  2006-12-28     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-8     Citation Subset:  IM    
Affiliation:
Department of Paediatrics and Child Health, University of Stellenbosch, Tygerberg Children's Hospital, Tygerberg, South Africa.
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MeSH Terms
Descriptor/Qualifier:
Bacteremia / complications*
Female
Fingers
Gangrene
Humans
Infant
Leeching*
Meningitis, Meningococcal / complications
Meningococcal Infections / complications*
Purpura, Schoenlein-Henoch / etiology*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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