Disseminated Intravascular Coagulation with Extensive Skin Lesions.

Abstract

Disseminated intravascular Coagulation (DIC) is a systemic syndrome characterized by widespread thrombosis, end-organ dysfunction, and, paradoxically, hemorrhage. DIC can manifest as an acute, life-threatening emergency or a chronic, subclinical process. This variation depends on the process's intensity, speed, and morbidities from its root cause, including trauma, sepsis, and malignancy. In DIC, cutaneous manifestations can be pronounced, with the severity of skin lesions often reflecting the seriousness of the underlying systemic disease. Stevens-Johnson Syndrome (SJS) is an immune-mediated mucocutaneous reaction that results in painful skin lesions leading to necrosis and sloughing. The cause is predominantly drug-induced. Necrotizing fasciitis is a bacterial infection resulting in extensive soft tissue necrosis, primarily superficial and deep fascia and overlying subcutaneous fat. In advanced stages, there is the development of large necrotic patches that appear black or gangrene. In this report, we describe a case of a patient who presented to the emergency department in septic shock due to bacteremia. The patient developed cutaneous lesions during their hospitalization, which broadened the differential as to what the cause may be. This case highlights the importance of recognizing DIC-induced skin necrosis in the setting of streptococcus pneumonia bacteremia