PURPURA fulminans is a rare disorder characterized by irregular but symmetrical areas of rapidly advancing intracutaneous and subcutaneous hemorrhage and necrosis. The entity is virtually limited to children, and until recently the mortality was over 90%. Unable to halt the inexorable progression of the disease, pediatricians in the past have seldom had occasion to bring the disorder to the attention of their surgical colleagues.
Purpura fulminans no longer has a hopeless prognosis. Although the cause and pathophysiology are incompletely understood, a variety of forms of treatment now appears capable of halting the progression of the disease. Our recent experiences with two surviving children emphasize the surgeon's role in the management of children with purpura fulminans.
Report of Cases
—The first child was a 22-month-old white boy who developed fever and urticaria a few days before admission. On the day of admission he was lethargic and anorectic with a