PMC6416646_01
Computed tomography of abdomen: Kidney with intravenous contrast shows multiple low density lesions and surrounding dirty fat sign. (white arrow).
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Contrast-enhanced computed tomography showed acute focal bacterial nephritis (Fig. 1).
Skin purpura and necrosis: The skin purpura presented from the face to the feet.
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Moreover, the patient's skin developed extensive purpura (Fig. 2, day 3), which was diagnosed by the dermatologist as purpura fulminans due to infection.
A. Hematoxylin-Eosin stain (scale x400), Black arrow shows necrosis of the skin and capillary without inflammatory cellular infiltration. B Masson trichrome stain (scale x400), White arrows show thrombosis of capillary vessel.
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Moreover, the patient's skin developed extensive purpura (Fig. 2, day 3), which was diagnosed by the dermatologist as purpura fulminans due to infection. Skin biopsy showed necrosis and bullae, and thrombosis, compatible with purpura fulminans. (Fig. 3 A, B) We planned to perform limb amputation after the patient's condition improved.