• Yue Wang, Cen Tang, Yajin Li, and Wanqin Hu.
• Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
• Medicine (Baltimore). 2024 Mar 29; 103 (13): e37571e37571.

RationalePuerperal sepsis is a life-threatening condition caused by infection that can rapidly progress to multisystem infection and toxin-mediated shock. Symmetrical peripheral gangrene is defined as symmetrical distal ischemic damage in two or more sites in the absence of major vascular occlusive disease. The syndrome is devastating and rare. In this study, we introduce a case of puerperal septicemia complicated by symmetrical peripheral gangrene.Patient ConcernsA 23-year-old woman delivered a live female infant vaginally after cervical balloon dilatation at 39 weeks of gestation. Persistent hyperthermia developed on the first postpartum day. After experiencing ventricular fibrillation, acute liver failure, and acute pulmonary edema, she developed blackened extremities on the 5th postpartum day.DiagnosesPuerperal septicemia complicated by symmetrical peripheral gangrene.InterventionsUpon transfer to our hospital, the patient was enrolled in the intensive care unit and underwent anti-infective and amputation surgery.OutcomesAfter the surgery, the patient recovered well and was successfully discharged from the hospital.LessonsEarly detection and timely treatment is the best way to reduce the mortality and sequelae of puerperal sepsis. Physicians should be alert to the possibility of comorbid symmetrical peripheral gangrene when sepsis patients present with hepatic impairment.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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