Purpura fulminans is a particularly malignant form of S-DIC associated with hemorrhagic infarction of dermal arteries.  This produces a characteristic pattern of confluent purpura which progresses to gangrene, typically involving the extremities.  Purpura fulminans is most often caused by profound bacterial sepsis (particularly meningococcus and pneumococcus).  One report detected low ADAMTS13 levels in two patients with purpura fulminans, suggesting that this disease could represent an overlap syndrome between S-DIC and sepsis-induced thrombotic thrombocytopenic purpura (TTP)


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