Generalized Shwartzman Reaction in Man After a Dog Bite

The first reported case of a generalized Shwartzman reaction complicating a dog bite occurred in a previously healthy 35-year-old man. Forty-eight hours after his left leg was bitten the patient developed fever, hypotension, symmetrical peripheral gangrene, anuria, and laboratory evidence of intravascular consumption of clotting factors. The patient died 1 month later, and postmortem examination showed pathologic changes representative of the human equivalent of a generalized Shwartzman reaction. The generalized Shwartzman reaction and the complications of dog bites are reviewed.