Arquivos de Medicina

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A Case of Diffuse Ischemic Limb Gangrene with Palpable Pulses in a Patient with Septic Shock

Dalvir Gill, Kamalpreet Mann, Sharanpreet Kaur, Vanessa Goyes Ruiz, Ryan Dean, Samana Zaidi

It is widely believed that ischemic limb gangrene is sequelae of arterial thrombosis or thromboembolism. In patients with severe sepsis, there is widespread activation of acute systemic inflammatory response. This can activate the coagulation cascade in the smaller vessels, therefore the pulse may still be palpable but patients may have ischemic injury due to vasoconstriction. Sepsis is also known to be associated with disseminated intravascular coagulation (DIC) because of hypercoagulable state and subsequent consumption of platelets and coagulation proteins.