Symmetrical peripheral gangrene following snake bite

Area of Science:

• Vascular Medicine
• Toxicology
• Dermatology

Background:

• Symmetrical peripheral gangrene (SPG) is characterized by distal ischemic damage at multiple sites without large vessel obstruction.
• SPG is associated with various conditions, including autoimmune diseases, infections, and iatrogenic causes.
• Few cases link SPG and acute renal failure to snake envenomation.

Observation:

• A 35-year-old Indian female presented with spontaneous gangrene of digits and toes.
• The gangrene developed symmetrically on the distal phalanges of fingers and all toes.
• The patient's condition followed a snake bite incident.

Findings:

• The case demonstrates a rare presentation of SPG following snake bite.
• The patient experienced gangrene in multiple distal extremities.
• Concurrent acute renal failure was noted, further complicating the clinical picture.

Implications:

• This case underscores the potential for severe peripheral ischemia and renal complications from snake bites.
• Highlights the importance of considering envenomation in the differential diagnosis of SPG.
• Suggests a need for further research into the pathophysiology of SPG secondary to snake venom.