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Critical Situations
February 2001

Symmetrical Peripheral Gangrene Due to Disseminated Intravascular Coagulation

Arch Dermatol. 2001;137(2):139-140. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-137-2-dcs00001

A 50-year-old white man developed fevers, chills, shortness of breath, and a cough that produced green sputum. Five days later, he was prostrate and was admitted to his local hospital with fulminant septic shock and associated disseminated intravascular coagulation, renal failure, and adult respiratory distress syndrome. Staphylococcus aureus was cultured from samples of his sputum and blood. He required ventilator support, fluids, and inotropic support to maintain arterial blood pressure, and he underwent hemodialysis for renal failure. He received intravenous antimicrobial therapy, initially with erythromycin, ceftriaxone, and gentamicin, later with piperacillin sodium–tazobactam sodium, and then with vancomycin hydrochloride.