Abstract
We describe a case of digital gangrene in a toddler with background disseminated tuberculosis
based on non response to antibiotic treatment for twenty four days, lack of BCG immunization,
positive contact with adult having chronic cough, favorable epidemiologic and radiologic
features of tuberculosis. She presented with fever, cough, vomiting, weight loss and
black discolouration of the fingers and toes. Patient was febrile (Temp 39.4°C), pale,
had digital gangrene, peripheral lymphadenopathy and weighed 75% of her expected body
weight. She was dyspnoeic, tachypnoec, respiratory rate of 42 cycles per minute with
crackles. Her pulse rate was 140 beat/minute (tachycardia), in addition to hepatosplenomegaly.
Chest X-ray showed features of consolidation, full blood count revealed packed cell
volume of 21%, eosinophilia of 8% and erythrocyte sedimentation rate (ESR) of 130
mm/Hr. Patient remarkably improved with anti-tuberculosis drugs and discharged on
follow-ups.
Keywords
Digital gangrene - disseminated tuberculosis - toddler - low health resource country
