Skin biopsy PCR for rapid microbiological diagnosis in patients with purpura fulminans

Abstract

Purpura fulminans (PF) is mostly caused by Neisseria meningitidis or Streptococcus pneumoniae. Prompt identification of the causative bacteria is essential, but cerebrospinal fluid (CSF) and blood cultures may lack sensitivity, mostly because of prior antibiotic administration, and be time-delayed. A skin biopsy of a purpuric lesion with N. meningitidis polymerase chain reaction (PCR) is now recommended by French guidelines, still, the usefulness of this tool remains debated in some countries, owing to the lack of high-level evidence.

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