Necrosis of both hands and feet in the course of streptococcal sepsis: a case report

A case of severe streptococcal phlegmon of the right upper extremity with subsequent necrosis of both hands and feet in a young, homeless alcoholic man is reported. The disease developed after a minor injury to the hand, and it progressed rapidly, resulting in the involvement of the whole hand and sepsis over 2 days. After admission, antibiotic and anticoagulant therapy was immediately administered, followed by wide surgical incisions on the hand and forearm. Nonetheless, over the course of 3 days, ischemia of the affected hand developed, followed by ischemia of the contralateral hand and both feet the next day. The treatment employed was not effective, and the patient eventually died on the fifth day after admission.