case_images: PMC10887867_01
case_images: The patient's left foot on admission and digital subtraction angiography findings. (A) Necrosis of the big toe with bluish-purple skin lesions on the foot; (B-D) Digital subtraction angiography showing patent superficial femoral artery, but the popliteal artery and the anterior tibial artery is occluded.
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case_images: A 53-year-old male was admitted to our hospital for skin ulceration on the left foot with febrile (39 C) for over a week (Figure 1A). Digital subtraction angiography demonstrated patent superficial femoral, posterior tibial, and distal peroneal arteries, with occlusion of the tibiofibular trunk, anterior tibial artery below the knee, and popliteal artery (Figure 1 B-D).
case_images: Amputation, pathergy and histopathologic examination. (A) Post-operative amputation showed a greenish-purple necrosis and punctate ulcers around the wound; (B) Ulcers at the cannulation site of right internal jugular vein. (C) Hematoxylin & Eosin stain showing numerous neutrophil infiltrates with skeletal muscle degeneration.
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case_images: Patient febrility did not improve after the operation, and purplish discoloration and punctate ulcers of the skin near the amputation site became apparent (Figure 2A). Five days after the amputation, an ulcer developed around the cannulation site of the right internal jugular vein (Figure 2B). Postoperative pathologic examinations revealed numerous neutrophil infiltrates with skeletal muscle degeneration (Figure 2C).
case_images: Follow-up findings. (A and B) The amputation site and the cannulation site at the right internal jugular vein have healed at 2-months follow-up.
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case_images: At the 2-month post-discharge follow-up, the patient's amputation wound and cannulation site ulcer were found to have healed (Figure 3).