Purpura Fulminans after Therapeutic Hypothermia in an Asphyxiated Neonate with Streptococcemia

Abstract

Objective Therapeutic hypothermia is an established therapeutic regimen in severely asphyxiated term neonates. The amount of cerebral injury is reduced resulting in an improved neurologic outcome. Therapeutic hypothermia-induced side effects mostly affect the circulatory system, kidney, and liver. However, asphyxia and hypothermia in itself reduce the hemostatic capacity of each individual organism.

Study Design A case of a neonate with severe asphyxia and purpura fulminans after hypothermia is described.

Results and Conclusion Although purpura fulminans cannot be attributed to hypothermia solely, the influence of hypothermia on hemostasis may have promoted severe coagulopathy with a fatal outcome. Further studies are necessary to reveal therapeutic hypothermia as a trigger for severe coagulopathies in asphyxiated neonates, especially in those with sepsis and overt coagulopathy prior to therapeutic hypothermia.

Keywords

asphyxia - therapeutic hypothermia - sepsis - purpura fulminans

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