Symmetrical Peripheral Gangrene and Falciparum Malaria: A Case Report and Review of all Cases

Abstract

| Introduction: Symmetrical Peripheral Gangrene (SPG) is defined as a symmetrical distal ischemic injury at two or more locations without any large vessels blockade. Malaria has been reported as one of the causes of SPG, although only 36 cases have been complicated with Symmetrical peripheral gangrene till date. Case Report: A 30-year male presented to us 15 days after the onset of malaria with gangrene of all four limbs with superadded infection. His wounds were debrided and amputated. Once the infection was controlled and gangrenous parts demarcated, amputations were done again for the lower limbs. Discussion: In P. falciparum infections, the processes of cytoadherence, rosetting, and agglutination are the factors responsible for the pathogenesis of SPG. It's vital to identify this rare, quickly developing complication. Heparin is being tried; blood transfusion has also been explored in the management of some of the patients but not found to be effective. If allowed to advance, surgical intervention is unavoidable.