ADAMTS13 and thrombotic thrombocytopenic purpura: The presence of neurological changes, nasal petechial rash, and fever reflects the classic TTP pentad, which is rarely seen in full during clinical practice [14]. Although ADAMTS13 testing was not available and thus definitive exclusion of true TTP was not possible, the rapid improvement following initiation of antimicrobial therapy without plasma exchange supports an infection-associated secondary TMA mimicking TTP [11]. True TTP has a mortality above 90% without initiation of plasma exchange [14].