Patients with cutaneous vasculitis may have underlying bacterial infections

A number of patients with cutaneous vasculitis may also have an underlying bacterial infection, according to researchers from the Hospital Universitario Marqués de Valdecilla and the rheumatology division of the Epidemiology, Genetics and Atherosclerosis Research Group in Santander, Spain.

Researchers studied a group of 766 patients diagnosed with cutaneous vasculitis (CV) at a single university referral center. CV was suspected in all patients with the main manifestation as a typical, palpable purpura without visceral vasculitic involvement. A severe, underlying bacterial infection was seen in 27 (3.5%) of the patients. Infections included eight cases of pneumonia, six cases of endocarditis, four cases of meningitis, three cases of intra-abdominal infections, two cases of septic arthritis, two cases of septicemia, and one case each of septic bursitis and urinary tract infection.

CV patients with bacterial infections were likely to be older and male and more frequently had fever, constitutional symptoms, focal infectious symptoms and leukocytosis with left shift and anemia, according to the researchers.

Antibiotics were prescribed for all patients, and seven required low-dose corticosteroids to completely resolve cutaneous lesions. Most experienced full recovery, but two underwent prosthetic cardiac valve replacement and two died from complications from infections. – by Shirley Pulawski

Reference:

Riancho-Zarrabeitia L, et al. Paper #2775. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: The authors have no relevant financial disclosures.