Purpura Fulminans Due to Escherichia coli Septicemia in Relapsed Acute Myeloid Leukemia: An Unusual Case of Protein C Deficiency and Disseminated Intravascular Coagulation.

Purpura fulminans (PF) is a rare and life-threatening condition characterized by rapid development of cutaneous microvascular thrombosis and skin necrosis, typically associated with disseminated intravascular coagulation (DIC). Here, we present a case of PF in an adult patient with relapsed acute myeloid leukemia (AML) who developed Escherichia coli (E. coli) septicemia. The patient's coagulopathy, including marked protein C deficiency, and immunosuppression required resuscitation, targeted antibiotic therapy, correction of hemostatic abnormalities, and surgical management. This case highlights the challenges of managing protein C deficiency and immunosuppression in PF, demonstrating how these interventions are critical to preventing progression and improving outcomes in this complex context.