Symmetrical Peripheral Gangrene: A Rare Clinical Syndrome

Symmetrical peripheral gangrene (SPG) is a rare syndrome which is defined by the peripheral ischemic lesion of two or more extremities in the absence of major vascular obstructive disease. We hereby describe a case of 63-year-old female, admitted in intensive care unit with a history of shortness of breath with atrial fibrillation since few days, developed cold extremity with acrocyanosis that rapidly progressed to gangrene. Laboratory analysis revealed increased inflammatory parameters, deranged liver enzymes, thrombocytopenia, and prolonged coagulation time. Patient developed septic shock and was started on intravenous vasopressor with clinical benefits. Even though there is no consensus regarding SPG treatment, consequences should be mitigated, particularly when vasopressor are used, in order to avoid major amputation. Most of the sepsis survivors with SPG require amputation of the affected extremities.