Modak Dolanchampa, Guha Subhasish K
School of Tropical Medicine, Kolkata, India.
Indian J Med Sci. 2012 Nov-Dec;66(11-12):292-5.
Symmetric peripheral gangrene is associated with a variety of infective and non-infective etiologies. SPG is always presented with disseminated intravascular coagulation (DIC) and carries a higher mortality. Herein, we describe a 42-year-old female with dengue fever and rash developed bilateral symmetric dry gangrene of 2 nd and 3 rd toes. There was no history of taking B-blockers, ergot etc. All the peripheral pulses of the affected limbs were palpable. Color Doppler of lower limb vessels was done, which indicated normal flow. Blood was positive for Fibrin degradation products and D dimers. Patient was managed with IV fluids, LMWH, FFP etc. Her general condition improved within 72 hours with no further progression of gangrene.
对称性外周坏疽与多种感染性和非感染性病因相关。对称性外周坏疽常伴有弥散性血管内凝血(DIC),死亡率较高。在此,我们描述一名42岁女性,患有登革热且出现皮疹,其第二和第三脚趾发生双侧对称性干性坏疽。患者无服用β受体阻滞剂、麦角等药物的病史。受累肢体的所有外周脉搏均可触及。对下肢血管进行了彩色多普勒检查,结果显示血流正常。血液中纤维蛋白降解产物和D-二聚体呈阳性。患者接受了静脉输液、低分子肝素、新鲜冰冻血浆等治疗。她的一般状况在72小时内有所改善,坏疽未进一步发展。