Affiliations: Department of Paediatrics, Federal Medical Centre
Yola, Yola, Nigeria
Note: [] Correspondence: Baba Usman Ahmadu, Department of Paediatrics,
Federal Medical Centre, Yola, Nigeria, Federal Medical Centre Yola, Adamawa
State, Nigeria, P.O. BOX 200 Jimeta-Yola, Adamawa State, Nigeria. Tel.: +234
8033668948; E-mail: [email protected]
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
