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Generalized Shwartzman Reaction in Man After a Dog Bite: Consumption Coagulopathy, Symmetrical Peripheral Gangrene, and Renal Cortical Necrosis

BURT R. MEYERS, M.D.; SHALOM Z. HIRSCHMAN, M.D., F.A.C.P.; and WILLIAM SLOAN, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Burt R. Meyers, M.D., Mount Sinai School of Medicine, 100th St. and Fifth Ave., New York, N.Y. 10029


New York, New York


Ann Intern Med. 1970;73(3):433-438. doi:10.7326/0003-4819-73-3-433
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The first reported case of a generalized Shwartzman reaction complicating a dog bite occurred in a previously healthy 35-year-old man. Forty-eight hours after his left leg was bitten the patient developed fever, hypotension, symmetrical peripheral gangrene, anuria, and laboratory evidence of intravascular consumption of clotting factors. The patient died 1 month later, and postmortem examination showed pathologic changes representative of the human equivalent of a generalized Shwartzman reaction. The generalized Shwartzman reaction and the complications of dog bites are reviewed.

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