Purple Man Syndrome: Purpura Fulminans Secondary to Meningococcemia

Invasive meningococcal disease is a serious life-threatening infection. Skin rash is present in about half of the patients with meningococcal infection. However it could be easily missed if no thorough cutaneous examination is performed. Herein, we present a patient with invasive meningococcal serogroup B infection with diffuse cutaneous purplish rash and ecchymoses, suggestive of purpura fulminans. Purpura fulminans is a telltale cutaneous manifestation of disseminated meningococcemia, and it is, unfortunately, an ominous late sign of infection. When present, the prognosis is grim with poor salvageable potential. We also describe how meningococcal serogroup B vaccines were introduced to the United States and their current indications of immunization.