Evolution of Purpura Fulminans - On physical examination, he had small purpura on his legs (Panel A) that spread to his face, abdomen, and limbs during the ensuing 3 hours. Treatment with broad-spectrum antibiotic agents was initiated immediately after blood specimens were obtained for culture. Over the next 6 hours, the purpura enlarged and spread further (Panel B), and signs of septic shock developed. #Clinical #Derm #EM #IM #PurpuraFulminans #Meningococcemia #NEJM