A RARE CASE OF SYMMETRICAL PERIPHERAL GANGRENE SECONDARY TO DIC IN THE CONTEXT OF E. COLI UROSEPSIS AND COMPLETE LIMB SALVAGE

Symmetrical peripheral gangrene (SPG) is an uncommon vascular emergency marked by ischemic injury to distal extremities in the absence of significant arterial blockage. We present a case of a 48-year-old female who suffered disseminated intravascular coagulation triggered by Escherichia coli urosepsis. The patient exhibited septic shock and acute renal damage, later manifesting peripheral cyanosis in all extremities. Laboratory results revealed disseminated intravascular coagulation (DIC) with D-dimer levels over 10,000 ng/ml and thrombocytopenia. Management comprised targeted antibacterial therapy, therapeutic heparin anticoagulation, bilateral ureteral stenting for source control, and supportive care. In contrast to the majority of documented cases of SPG that generally necessitate amputation, our patient attained full recovery without advancing to overt gangrene. This example demonstrates that prompt identification and comprehensive care can significantly improve outcomes in SPG, counteracting the high morbidity typically associated with this illness.