Abstract:
:An older female underwent bariatric surgery which was followed by a significant weight loss and diarrhea, from which C. difficile was isolated just before her hospitalization. Less than 48 hours after admission, she became febrile, developed deep venous thrombosis of the leg and a pulmonary embolus. Blood cultures grew out Streptococcus pneumoniae and the patient developed purpura fulminans. There was convincing laboratory evidence for disseminated intravascular coagulation and a marked depletion of proteins C and S as well as antithrombin. Treatment with ceftriaxone and drotrecogin alfa together with parenteral nutrition led to disappearance of the pathogen and ultimate normalization of the anticoagulant factors. We believe that malabsorption of vitamin K dependent proteins C, S and antithrombin due to bariatric surgery predisposed the patient to purpura fulminans and disseminated intravascular coagulation.
journal_name
Obes Surgjournal_title
Obesity surgeryauthors
Cone LA,B Waterbor R,Sofonio MVdoi
10.1381/096089204323093507subject
Has Abstractpub_date
2004-05-01 00:00:00pages
690-4issue
5eissn
0960-8923issn
1708-0428journal_volume
14pub_type
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