SEVERE PURPURA WITH GANGRENE OF THE LOWER EXTREMITY FOLLOWING SCARLET FEVER

Abstract

Gangrene of the extremities is one of the rare complications of scarlet fever. In a review of the literature, reports of only fifteen cases have been found, eleven of which were available for study. The first were by Lister¹and Hudson²in 1858, followed later by those of Tungel,³Mayr,⁴Blaupain,⁵Kuster,⁶Holmes,⁷Chapin,⁸Pearson and Littlewood,⁹Eichhorst,¹⁰Buchan,¹¹Hoyne,¹²Learmouth,¹³Schamberg and Kolmer,¹⁴and Sutherland.¹⁵ In the eleven cases reviewed, the age ranged between 3 and 40 years. They were about equally divided as to sex. The family history, when available, was negative for syphilis, tuberculosis and any hemorrhagic diathesis. The attack of scarlet fever in all cases was relatively mild, except that in Buchan's case, which was quite severe. Over half the cases occurred with some other complication, five with nephritis (two with