• J F Cnota, L L Barton, and K H Rhee.
• Department of Pediatrics and The Steele Memorial Children's Research Center, University of Arizona School of Medicine, Tucson, USA.
• Pediatr Emerg Care. 1999 Jun 1; 15 (3): 187-8.

BackgroundNeisseria meningitidis is the most frequent isolate associated with purpura fulminans in children. Although Streptococcus pneumoniae infection has been associated with purpura fulminans, with the exception of one adult, it has only been reported in immunocompromised hosts.PurposeWe report an apparently previously healthy child who presented with purpura fulminans associated with pneumococcal meningitis.MethodsCase report and review of the medical literature from September 1966 to June 1997, using a MEDLINE search.ConclusionWhile systemic pneumococcal infection is common in childhood, progression to purpura fulminans does not typically occur in overtly healthy children. Our patient illustrates that invasive pneumococcal infection should be considered and empirically treated in a child who presents with purpura fulminans, even in the absence of preexisting functional or anatomic asplenia.

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