Symmetrical peripheral gangrene and disseminated intravascular coagulation

Community Acquired Methicillin Resistant Staphylococcus Aureus: A Rare Presentation

“…Immunosuppression, cold injury, diabetes mellitus and vasopressors are aggravating factors [8]. Up to 85% of patients have disseminated intravascular coagulation and 50% who survive require amputation of the affected limb [9]. The primary treatment includes treatment of the underlying cause [10].…”

Symmetrical Peripheral Gangrene after Suprapubic Prostatectomy

“…It is a rare complication in patients presenting with one or more of the following conditions: multiple organ failure (3), septicemia (4, 5), DIC (6), cardiogenic and hypovolemic shock (7), vasopressor therapy (7,8), paraneoplastic syndromes (9), myoglobulinuria, C-protein de ciency, polymyalgia rheumatica or Raynaud's phenomenon and sickle cell disease (3). The mortality rate ranges from 30% to 35% (4) and 48% of surviving patients have at least one limb amputated (6).…”

Arterial cannulation can hasten the onset of symmetrical peripheral gangrene

“…[2] SPG can also occur as a complication of measles,[3] chickenpox,[4] malignancy, and ergotism. Aggravating factors are increased sympathetic tone,[2] diabetes mellitus,[2] immunosuppression,[5] cold injury to extremities,[6] use of vasopressors,[6] and renal failure. [7]…”

“…[5] Low-flow state and septicemic conditions are almost invariably present. Fever followed by marked coldness, pallor, cyanosis, pain, and restricted mobility of extremity should always raise suspicion of SPG.…”