This case is of special interest for three reasons; first, because of the infrequency of gangrene of the extremities following pneumonia; second, because the gangrene occurred in both legs at about the same time and to the same extent; third, because the emboli causing the gangrene were located in about the same place in the popliteal arteries.
After reviewing the literature on this subject, several causes are given for gangrene in children, namely, burns,1 local actions of chemicals, diseases of the nervous system (Raynaud's disease), constitutional diseases (hemophilia, purpura, and diabetes), thrombosis and embolism, and gangrene following measles, scarlet fever, diphtheria, varicella, erysipelas and typhoid fever. I was unable to find a single case of bilateral gangrene following pneumonia.
As to the frequency of gangrene, Frenkel2 after reviewing the literature found fifty cases on record following measles, diphtheria, syphilis, and other infectious diseases. Two of the cases followed
HARRELL HP. REPORT OF A CASE OF GANGRENE OF LEGS FOLLOWING BRONCHOPNEUMONIA. Am J Dis Child. 1924;27(6):562-564. doi:10.1001/archpedi.1924.01920120024003