Incipient Symmetrical Peripheral Gangrene Complicating Pneumonia

Abrahams (1948) reported a case of incipient symmetrical peripheral gangrene complicating paroxysmal tachycardia. Swan and Henderson (1951) reported two cases of the same condition in myocardial infarction. It may therefore be' worth while giving an account of another case of symmetrical peripheral gangrene, apparently provoked by pneumonia. The analytical studies of the gases of the arterial blood and the post-mortem examination may throw some light of the pathogenesis of this condition. Case Report S. O., a 58-year-old shop-assistant, was healthy until about October 20, 1948, three weeks before admission, when she started lo become breathless. She had to stop and rest repeatedly on her way home after the days work. A couple of days later her fingers began to swell, especially in the morning, the swelling diminishing a little during the day. After a week the fingertips started to get blue, and at the same time the fingers became painful. The pains were constant and resembled tooth-ache, becoming worse while she was at work, packing and delivering cakes and pastries. After some days she therefore had to stop work. She consulted a physician, who gave her some- thing to relieve the pain. At night she slept with her arms above her head, as this position relieved the pain somewhat. Her dyspncea continued, but she had no pain in her chest and no cough.