Presentation
Rapid onset of systemic illness.
Patient Data
Right upper lobe consolidation present. The left lung is clear. No evidence of pneumothorax or pleural effusion. No evidence of cavitation.
This patient went on to deteriorate rapidly, was intubated and spent a few weeks in ICU with multi-organ failure. During that time his hands were noted to be abnormal.
The soft tissues of the tips of the first, second, third and fourth digits are markedly atrophic. The second digit seems most severely affected, without however convincing evidence of osteomyelitis or septic arthritis. The remainder of the hands appear essentially unremarkable, other than some periarticular osteopenia.
Case Discussion
This case demonstrates peripheral necrosis of the fingertips, in this case, due to pneumococcal sepsis.
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