Severe disseminated intravascular coagulation often complicates cases of septicemia caused by

• A. Acinetobacter sp.
• B. Neisseria meningitidis
• C. Moraxella sp.
• D. Neisseria gonorrhoeae

Answer: (B)

Severe disseminated intravascular coagulation in the setting of septicemia is driven by an overwhelming inflammatory response that activates the coagulation system throughout the microvasculature. Neisseria meningitidis, the meningococcus, is especially prone to this because its endotoxin triggers a robust cytokine surge (TNF, IL-1, IL-6) and rapid expression of tissue factor on monocytes and other cells. This pushes the coagulation cascade forward, creating widespread microthrombi while consuming platelets and clotting factors. The result is a consumption coagulopathy with bleeding tendencies and often characteristic purpura or purpura fulminans, and it can progress to shock and organ failure. While other bacteria can cause sepsis, the abrupt, severe DIC with purpura fulminans is most strongly associated with meningococcal septicemia.