Symmetrical peripheral gangrene triggered by Escherichia coli sepsis

Rationale: Symmetrical peripheral gangrene is a rare acute condition triggered by several medical conditions. It needs to be recognized early and treated as an emergency. Patient’s Concern: A 40-year-old patient without any comorbidities presented with sudden onset of pain, swelling, blistering and bluish discoloration of the fingers and toes associated with fever and constitutional symptoms. Later the fingers and toes turned dark and they were cold to touch. Diagnosis: Diagnosis of symmetrical peripheral gangrene was made and investigated. Blood culture isolated Escherichia coli indicating a possible role in the causation of symmetrical peripheral gangrene. Interventions: Patient was managed with antibiotics and anticoagulants along with supportive care. Outcomes: There was improvement in patient’s general condition along with development of gangrene demarcation line of the fingers and toes. Lessons: Awareness of this condition is needed and an early management is recommended including recognizing the cause and supportive therapy to prevent complications.