This case involved a previously healthy 67-year-old male patient who presented with nearly fatal urosepsis from kidney stones. During this acute illness, he developed multisystem organ failure that required aggressive treatment. He survived the event, but sustained serious microvascular injury to his fingers and toes although his large vessels and pulses remained intact.
Unfortunately, all of the patient’s toes and several of his fingers developed gangrene. The medical team was able to salvage most of the fingers, but the toes required amputation after final demarcation. The lateral heels were gangrenous as well and the patient developed osteomyelitis. He was treated aggressively over the following months with home health care, multiple antibiotics, VAC treatments, and multiple debridements. The wounds waxed and waned, but ultimately the patient required bilateral below-the-knee amputations.