Purpura fulminans: an unusual manifestation of severe falciparum malaria

Abstract

We describe a 67-year-old Japanese woman who contracted severe falciparum malaria in sub-Saharan Africa. The patient had impaired consciousness, jaundice and acute renal failure. Most interestingly, she manifested purpura fulminans, a cutaneous sign of disseminated intravascular coagulation, which rarely develops in severe falciparum malaria. She required intensive treatment, including haemofiltration, plasma exchange and digital amputation, to recover. This case provides further evidence that purpura fulminans is a potential clinical manifestation of severe falciparum malaria.