Refractory gram-negative septic shock complicated by extended purpura fulminans and multiple organ failure in 23-year-old puerpera: A case report.

Background Pregnancy-related infections are the third most common cause of maternal death worldwide. Case A 23-year-old postpartum woman developed fulminate, refractory septic shock complicated by purpura fulminans, multiple organ failure syndrome (acute respiratory distress syndrome, acute kidney injury, encephalopathy). Patient's management included antibacterial therapy, fluid and transfusion therapy, nutrition support, protective mechanical ventilation, hydrocortisone, a large dose of ascorbic acid and thiamine. There were no neurological consequences and all organ functions returned to normal parameters despite SOFA score-predicted hospital mortality was higher than 90 %. Conclusions Septic shock is a significant and yet not completely understood life-threatening condition which can be associated with purpura fulminans, multiple organ dysfunction, disseminated intravascular coagulation and massive tissue necrosis.