Peripheral gangrene complicating Salmonella typhi septicaemia in a Gambian infant

A 1-year-old malnourished boy, who presented with Salmonella typhi septicaemia with a 4-day history of febrile illness, dehydration and severe anaemia, developed bilateral dry gangrene of the hands and feet. Although he improved appreciably, he suffered auto-amputation of the distal phalanges of the left foot after 3 weeks of illness. A high index of suspicion and prompt treatment is highly critical in the treatment of septicaemia in young children.