Symmetrical Peripheral Gangrene of All Four Limbs of Unknown Etiology: a Rare Case Report

Symmetrical peripheral gangrene is a rare entity with high mortality, up to 40%. It is most often caused because of high-dose vasopressors, sepsis, disseminated intravascular coagulation (DIC), drugs, or malignancy. We are reporting a case of 45-year-old male patient, without any comorbidities presenting with dry gangrenous changes in all four limbs of sudden onset, which progressed to wet gangrene of lower limbs. The patient underwent bilateral above-knee amputation and right upper limb below-elbow amputation, and left hand got auto-amputated. However, even after a series of investigations, no etiology could be found.