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A Genetic Origin? Purpura Fulminans

Published:October 24, 2018DOI:https://doi.org/10.1016/j.amjmed.2018.10.003
      Over days, a patient's relatively small lesion evolved into widespread tissue damage. A previously healthy 49-year-old Arab woman was admitted for a 2-cm painful red lesion on her left breast. She had been well until a few days earlier, when she developed left flank pain and was treated with ofloxacin for a presumed urinary tract infection. During the first 48 hours of her admission, the erythematous lesion over the left breast progressed, developing the appearance of a hematoma. Ultimately, it involved the entire breast (Figure 1). The patient denied trauma. At the same time, her hemoglobin level decreased by 2 g/dL. Her prothrombin time, partial thromboplastin time, fibrinogen concentration, and platelet count were all within normal limits.
      Figure 1
      Figure 1The patient's left breast appeared to have an extensive hematoma with a clearly demarcated border.

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