DIC

Question 1

May be caused by?

Answer 1

Bacterial sepsis, obstetric complications, disseminated malignancy, and massive trauma.

Question 2

Skin lesions

Answer 2

Hours to days; rapid evolution. Fever and chills associated with onset of hemorrhagic lesions.

SKIN LESIONS Infarction (purpura ulminans): Massive ecchymoses with sharp, irregular (“geographic”) borders with deep purple to blue color and erythematous halo, ± evolution to hemorrhagic bullae and blue to black gangrene ;multiple lesions are often symmet- ric; distal extremities,areas of pressure;lips, ears, nose, and trunk; peripheral acrocyanosis
followed by gangrene on the hands, feet, and tip of nose, with subsequent autoamputation if patient survives.
Hemorrhage from multiple cutaneoussites,i.e., surgical incisions, venipuncture, or catheter sites.

Question 3

Mucous lesion

Answer 3

hemorrhage from gingiva

Question 4

General examination

Answer 4

High fever,tachycardia, ± shock

Question 5

Laboratory

Answer 5

DERMATOPATHOLOGY Occlusion of arterioles with fibrin thrombi.
Dense neutrophilic in lnfiltrate around infarct and massive hemorrhage.

HEMATOLOGICSTUDIES CBC. Schistocytes ( rag- mented RBCs), arising from RBC entrapment and damage within fibrin thrombi, seen on blood smear; platelet count low. Leukocytosis. Coagulation Studies. Reduced plasma fibrinogen; elevated fibrin degradation products; prolonged prothrombin time, partial thrombo- plastin time and thrombin time.

BLOOD CULTURE For bacterial sepsis

Question 6

Mortality is high or low?

Complications.

Answer 6

Mortality rate is high. Surviving patients require skin grafts for amputation or gangrenous tissue.

Common complications: Severe bleeding, thrombosis, tissue ischemia/necrosis, hemolysis,and organ failure

Question 7

management

Answer 7

Vigorous antibiotic therapy for infections.

Control bleeding or thrombosis:Heparin,pentoxi phylline, protein C concentrate, intravenous immunoglobulin, and FFP.