Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation

Adolfo Leyva-Alvizo; Cristina Villar-Canton; Alberto Riojas-Garza

doi:doi:10.11648/j.wjmcr.20220302.13

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Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation

Adolfo Leyva-Alvizo, Cristina Villar-Canton, Alberto Riojas-Garza

Published in World Journal of Medical Case Reports (Volume 3, Issue 2)

Received: 12 April 2022 Accepted: 26 April 2022 Published: 10 May 2022

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Abstract

Increased incidence of thromboembolic events in patients with severe COVID-19 infection has been documented. Acute limb ischemia as a complication in critically ill patients due to coagulopathy has been reported, worsening prognosis and increasing limb amputation rate. Delayed recognition could lead to irreversible ischemia and clinical deterioration requiring amputation. We present the case of a 54-year-old male with severe COVID-19 infection who developed clinical deterioration and acute lower limb ischemia at day 7 of hospitalization in the intensive care unit. Skin color changes suggested necrotic tissue and skin bullae. Arterial doppler ultrasound revealed a thrombus on the distal superficial femoral artery with absence of blood flow. Irreversible ischemia was diagnosed. The patient underwent an above the knee amputation, showing favorable clinical evolution during the next three days. Nonetheless, septic shock persisted, and 14 days later the patient presented cardiorespiratory arrest and passed away. Acute limb ischemia could present as a complication in critically ill patients treated in the intensive care unit, increasing amputation rate and worsening prognosis. In patients with critical management, physical examination and laboratory analyses are essential for clinical evolution concerning peripheral vascular disease. Efforts should be made to diagnose such complications on time with a more rigorous and protocolized limb perfusion examination.

Published in	World Journal of Medical Case Reports (Volume 3, Issue 2)
DOI	10.11648/j.wjmcr.20220302.13
Page(s)	25-28
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Limb Ischemia, Amputation, COVID-19, Septic Shock

References

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[10]	Xiong M, Liang X, Wei Y-D. Changes in blood coagulation in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Vol. 189, British journal of haematology. 2020. p. 1050–2.
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[15]	Kaur P, Posimreddy S, Singh B, Qaqa F, Habib HA, Maroules M, et al. COVID-19 Presenting as Acute Limb Ischaemia. Eur J case reports Intern Med. 2020; 7 (6): 1724.
[16]	Kaur P, Qaqa F, Ramahi A, Shamoon Y, Singhal M, Shamoon F, et al. Acute upper limb ischemia in a patient with COVID-19. Hematology/oncology and stem cell therapy. 2020.
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Adolfo Leyva-Alvizo, Cristina Villar-Canton, Alberto Riojas-Garza. (2022). Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation. World Journal of Medical Case Reports, 3(2), 25-28. https://doi.org/10.11648/j.wjmcr.20220302.13

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ACS Style

Adolfo Leyva-Alvizo; Cristina Villar-Canton; Alberto Riojas-Garza. Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation. World J. Med. Case Rep. 2022, 3(2), 25-28. doi: 10.11648/j.wjmcr.20220302.13

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AMA Style

Adolfo Leyva-Alvizo, Cristina Villar-Canton, Alberto Riojas-Garza. Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation. World J Med Case Rep. 2022;3(2):25-28. doi: 10.11648/j.wjmcr.20220302.13

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@article{10.11648/j.wjmcr.20220302.13,
  author = {Adolfo Leyva-Alvizo and Cristina Villar-Canton and Alberto Riojas-Garza},
  title = {Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation},
  journal = {World Journal of Medical Case Reports},
  volume = {3},
  number = {2},
  pages = {25-28},
  doi = {10.11648/j.wjmcr.20220302.13},
  url = {https://doi.org/10.11648/j.wjmcr.20220302.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20220302.13},
  abstract = {Increased incidence of thromboembolic events in patients with severe COVID-19 infection has been documented. Acute limb ischemia as a complication in critically ill patients due to coagulopathy has been reported, worsening prognosis and increasing limb amputation rate. Delayed recognition could lead to irreversible ischemia and clinical deterioration requiring amputation. We present the case of a 54-year-old male with severe COVID-19 infection who developed clinical deterioration and acute lower limb ischemia at day 7 of hospitalization in the intensive care unit. Skin color changes suggested necrotic tissue and skin bullae. Arterial doppler ultrasound revealed a thrombus on the distal superficial femoral artery with absence of blood flow. Irreversible ischemia was diagnosed. The patient underwent an above the knee amputation, showing favorable clinical evolution during the next three days. Nonetheless, septic shock persisted, and 14 days later the patient presented cardiorespiratory arrest and passed away. Acute limb ischemia could present as a complication in critically ill patients treated in the intensive care unit, increasing amputation rate and worsening prognosis. In patients with critical management, physical examination and laboratory analyses are essential for clinical evolution concerning peripheral vascular disease. Efforts should be made to diagnose such complications on time with a more rigorous and protocolized limb perfusion examination.},
 year = {2022}
}

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TY - JOUR
T1 - Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation
AU - Adolfo Leyva-Alvizo
AU - Cristina Villar-Canton
AU - Alberto Riojas-Garza
Y1 - 2022/05/10
PY - 2022
N1 - https://doi.org/10.11648/j.wjmcr.20220302.13
DO - 10.11648/j.wjmcr.20220302.13
T2 - World Journal of Medical Case Reports
JF - World Journal of Medical Case Reports
JO - World Journal of Medical Case Reports
SP - 25
EP - 28
PB - Science Publishing Group
SN - 2994-726X
UR - https://doi.org/10.11648/j.wjmcr.20220302.13
AB - Increased incidence of thromboembolic events in patients with severe COVID-19 infection has been documented. Acute limb ischemia as a complication in critically ill patients due to coagulopathy has been reported, worsening prognosis and increasing limb amputation rate. Delayed recognition could lead to irreversible ischemia and clinical deterioration requiring amputation. We present the case of a 54-year-old male with severe COVID-19 infection who developed clinical deterioration and acute lower limb ischemia at day 7 of hospitalization in the intensive care unit. Skin color changes suggested necrotic tissue and skin bullae. Arterial doppler ultrasound revealed a thrombus on the distal superficial femoral artery with absence of blood flow. Irreversible ischemia was diagnosed. The patient underwent an above the knee amputation, showing favorable clinical evolution during the next three days. Nonetheless, septic shock persisted, and 14 days later the patient presented cardiorespiratory arrest and passed away. Acute limb ischemia could present as a complication in critically ill patients treated in the intensive care unit, increasing amputation rate and worsening prognosis. In patients with critical management, physical examination and laboratory analyses are essential for clinical evolution concerning peripheral vascular disease. Efforts should be made to diagnose such complications on time with a more rigorous and protocolized limb perfusion examination.
VL - 3
IS - 2
ER -

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Author Information

Adolfo Leyva-Alvizo

School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México
Cristina Villar-Canton

School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México
Alberto Riojas-Garza

School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México

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APA Style

Adolfo Leyva-Alvizo, Cristina Villar-Canton, Alberto Riojas-Garza. (2022). Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation. World Journal of Medical Case Reports, 3(2), 25-28. https://doi.org/10.11648/j.wjmcr.20220302.13

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ACS Style

Adolfo Leyva-Alvizo; Cristina Villar-Canton; Alberto Riojas-Garza. Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation. World J. Med. Case Rep. 2022, 3(2), 25-28. doi: 10.11648/j.wjmcr.20220302.13

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AMA Style

Adolfo Leyva-Alvizo, Cristina Villar-Canton, Alberto Riojas-Garza. Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation. World J Med Case Rep. 2022;3(2):25-28. doi: 10.11648/j.wjmcr.20220302.13

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@article{10.11648/j.wjmcr.20220302.13,
  author = {Adolfo Leyva-Alvizo and Cristina Villar-Canton and Alberto Riojas-Garza},
  title = {Acute Lower Limb Ischemia in a Patient with COVID-19 and Septic Shock Requiring Amputation},
  journal = {World Journal of Medical Case Reports},
  volume = {3},
  number = {2},
  pages = {25-28},
  doi = {10.11648/j.wjmcr.20220302.13},
  url = {https://doi.org/10.11648/j.wjmcr.20220302.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20220302.13},
  abstract = {Increased incidence of thromboembolic events in patients with severe COVID-19 infection has been documented. Acute limb ischemia as a complication in critically ill patients due to coagulopathy has been reported, worsening prognosis and increasing limb amputation rate. Delayed recognition could lead to irreversible ischemia and clinical deterioration requiring amputation. We present the case of a 54-year-old male with severe COVID-19 infection who developed clinical deterioration and acute lower limb ischemia at day 7 of hospitalization in the intensive care unit. Skin color changes suggested necrotic tissue and skin bullae. Arterial doppler ultrasound revealed a thrombus on the distal superficial femoral artery with absence of blood flow. Irreversible ischemia was diagnosed. The patient underwent an above the knee amputation, showing favorable clinical evolution during the next three days. Nonetheless, septic shock persisted, and 14 days later the patient presented cardiorespiratory arrest and passed away. Acute limb ischemia could present as a complication in critically ill patients treated in the intensive care unit, increasing amputation rate and worsening prognosis. In patients with critical management, physical examination and laboratory analyses are essential for clinical evolution concerning peripheral vascular disease. Efforts should be made to diagnose such complications on time with a more rigorous and protocolized limb perfusion examination.},
 year = {2022}
}

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