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.
Resumen
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.
Por qué esto importa para la hirudoterapia
Este caso clínico describe una lactante de sexo femenino de 5 semanas de edad con meningitis meningocócica, septicemia y púrpura fulminante progresiva de la mano izquierda, que fue tratada con sanguijuelas medicinales aplicadas sobre el dorso de la mano de forma diaria durante cuatro días consecutivos. La mejoría visible de la tumefacción y la función se observó a las 48 horas, y la perfusión de la falange distal del pulgar y del dedo medio fue evidente a las 120 horas, si bien la reperfusión completa no se mantuvo y fue necesario el desbridamiento quirúrgico de varias falanges distales (excluyendo el pulgar) a las seis semanas. El caso es directamente relevante para ASH, ya que documenta la hirudoterapia para dedos isquémicos en una lactante con púrpura fulminante. La limitación radica en que se trata de un caso clínico único sin grupo control; se produjo pérdida parcial de los dedos a pesar del tratamiento, y los autores señalan que los beneficios siguen siendo teóricos y requieren estudios futuros.
Citación
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
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026