Clinical Presentation and Treatment of Thromboangiitis Obliterans With Superimposed Osteomyelitis

Thromboangiitis obliterans (TAO) is an autoimmune vasculitis that typically presents in male smokers between the ages of 25 and 40. Although TAO primarily affects medium-sized blood vessels, it can also infiltrate small blood vessels as well as nerves and veins. The inflammation can cause segmental thrombosing and occlusion of the blood vessels leading to gangrene and eventual amputations. This case presents a unique sequela of TAO, in which a 28-year-old male with a chronic tobacco smoking history was diagnosed with TAO after presenting with pain and discoloration in his foot, in addition to superimposed osteomyelitis. This case serves to remind emergency clinicians, internal medicine physicians, general practitioners, and infectious disease specialists of the TAO differential in patients presenting with pain and discoloration in the feet, as well as the importance of working up the patient for any superimposed infections.