Acute Infectious Purpura fulminans in A 2-Year Old Child

Purpura fulminans (PF) is a rapidly progressing clinical syndrome of haematologic and cutaneous manifestations accompanied by an underlying dysfunction of coagulation resulting in disseminated intravascular coagulation (DIC). It is a life threatening haematologic emergency characterized by extensive skin necrosis with haemorrhagic infarction, hypotension and gangrene which may arise from severe sepsis, mostly gram negative organisms. Some gram positive organisms and viral infections have been implicated in the aetiology of PF. We reported a case of purpura fulminans in a 2 year old boy with severe sepsis and peripheral gangrene from gram positive coccus (Staphylococcus aureus). Even though we were faced with limitations in terms of laboratory support and parental financial constraints in the management of the patient; he survived mainly on supportive care and antibiotics.

Cerebral Venous Infarction due to Internal Jugular Vein Thrombosis: A Case Study and Review of Literature

Cerebral venous sinus thrombosis (CVST) is an uncommon disease entity. In contrast-enhanced computed tomography (CT) or magnetic resonance venography (MRV) images of the brain, CVST usually manifests as a filling defect of the dural venous sinuses. Brain parenchymal involvement in CVST can be ranged from parenchymal oedema to haemorrhagic infarctions. Though the most frequent cause of haemorrhagic infarction in brain is CVST, other rare causes such as cerebral venous outflow obstruction due to neck vein pathology have been reported. We report a rare case of haemorrhagic brain infarctions secondary to bilateral internal jugular vein thrombosis in a 17-year-old woman, who has presented with worsening headache and seizures. She had high susceptibility of getting venous thrombosis for being a young female on oral contraceptive pills. While reporting a rare cause of cerebral haemorrhagic infarctions, this case report highlights the need for having a high degree of suspicion to diagnose CVST. Further, this case report emphasises the value of prompt and adequate imaging of neck veins if the haemorrhagic infarction presents with patent cerebral venous sinuses.

Case Report: Traumatic vein of Labbé hemorrhagic infarction - a distinct neurosurgical entity

Traumatic vein of Labbé haemorrhagic infarction is a distinct neurosurgical entity which requires special attention due to the important nature of the area it drains and its higher propensity for early uncal herniation. Herein we discuss the case of a 55 year-old male presenting with altered sensorium following a road traffic accident. His computerized tomogram (CT) head was suggestive of traumatic vein of Labbé haemorrhagic infarction which was subsequently confirmed by magnetic resonance (MR) venography. Due to impending herniation, he underwent urgent craniotomy and evacuation of hematoma.The patient made an uneventful recovery and was subsequently discharged home.This diagnosis should always be kept in mind for a patient with petrous bone fracture, transverse sinus thrombosis and hematoma in the mid and posterior temporal lobe.