Meningococcal purpura fulminans treated with medicinal leeches
Case report published in Pediatr Crit Care Med (2006)
Abstract
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.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
5-week-old infant with meningococcal septicemia and progressive purpura fulminans treated daily with medicinal leeches for 4 days. Swelling and limited functionality visibly improved at 48 hours, with reperfusion of distal phalanges by 120 hours.
Warum dies für die Hirudotherapie relevant ist
This case report describes a 5-week-old female infant with meningococcal meningitis, septicemia, and progressive purpura fulminans of the left hand who was treated with medicinal leeches applied to the dorsal hand daily for four consecutive days. Visible improvement in swelling and function occurred after 48 hours, and distal phalanx perfusion of the thumb and middle finger was evident by 120 hours, though full reperfusion was not sustained and surgical debridement of several distal phalanges (excluding the thumb) was required at six weeks. The report is directly relevant to ASH as it documents hirudotherapy for ischemic digits in an infant with purpura fulminans. The limitation is that this is a single case report with no control group; partial digit loss occurred despite treatment, and the authors note that benefits remain theoretical and require future study.
Zitation
Meningococcal purpura fulminans treated with medicinal leeches.
Dippenaar R et al. · Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2006
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