European Journal of Biomedical and Pharmaceutical Sciences

SYMMETRICAL PERIPHERAL GANGRENE: A CASE REPORT

*Dr. Dhanwantari Shukla, Dr. Ajay Sharma and Dr. Shambhu Dayal Barua

ABSTRACT

Symmetrical peripheral gangrene (SPG) is a rare clinical syndrome of symmetrical gangrene of two or more sites in absence of large vessel obstruction or vasculitis.[1] Most commonly affected areas are distal extremities, tip of nose, scalp, genitalia and margin of pinna.2 Exact pathogenesis of the condition is yet elusive, but low-flow circulatory states, vasospastic conditions and hypercoagulable states arising out of sepsis, vasoactive drugs, cardiovascular insufficiency, certain malignancies and connective tissue disorders are associated with this deadly condition.1 DIC (Disseminated intravascular coagulation) is believed to be the final common pathway of pathogenesis in about 85% of cases.3 Unless suspected at an incipient stage and a meticulous search to identify and eliminate the offending agent is made, the condition may progress rapidly, leading to loss of limbs and frequently lives. A multidisciplinary team consisiting of intensivists, surgeons and dermatologists is required for comprehensive management of such patients during their acute illness and chronic debilitation.1 Here, we present a case of an otherwise healthy, 4 year old boy who suffered from symmetrical gangrenous changes in all 4 limbs, following a febrile attack of pneumonia.

Keywords: Symmetrical peripheral gangrene, DIC, pneumonia.