Distal Ischemia of the Four Limbs: A Case Report and Literature Review

Abstract

The symmetrical peripheral gangrene syndrome is characterized by ischemic distal lesions in two or more extremities, without the obstruction of large vessels. The ischemia affecting extremities takes place when the arterial blood flow is insufficient to satisfy the metabolic demands of muscles in rest. We present a 22-year-old patient treated with norepinephrine after a septic shock suspicion who presented distal ischemia of fingers, toes, and scalp. There is no consensus about the initial treatment. Improved data gathering is necessary for a better understanding of the mechanisms involved, which could improve treatment and prevent amputation as the final therapeutic option.

Postpartum septic shock presenting as symmetrical peripheral gangrene: A rare entity

“…Hector Masaragian et al, present a case of four-limb gangrene resulting from septic shock after surgical rhinoplasty. 8 SPG is a rare entity hence, no specific guidelines have been formulated for its management. The management is supportive with antibiotics, hydration, correction of electrolytes and coagulation profile, and treating the underlying precipitating factor.…”

“…Regrettably, established gangrene cannot be reversed despite good maintenance of blood flow which ultimately results in amputation. 7,8 However, aggressive and prompt management limits progression to gangrene and reverses ischemia.…”