Meningococcemia

A 31-year-old woman without history of systemic diseases presented to the emergency department with spiking fever, chills, generalized myalgia, severe epigastralgia, and watery diarrhea for 1 day. Flulike symptoms had been noted for several days. Progressive extension of petechiae skin purpura (Fig. 1) developed within 2–3 h upon arrival at the hospital. Low blood pressure persisted despite vigorous fluid resuscitation. Laboratory results showed bandemia without obvious leukocytosis, low platelet counts, severe metabolic acidosis, and prolonged prothrombin time and partial thromboplastin time. Computed tomography of the abdomen was arranged to search for a possible intra-abdominal lesion, which could be causing the septic shock and severe abdominal pain (Fig. 2). The patient died after approximately 10 h of vigorous fluid resuscitation, inotropic agents, and antibiotics with quinolones. No emergent dialysis was arranged.