BILATERAL GANGRENE OF THE FEET FOLLOWING TONSILLECTOMY

A search of the literature has failed to reveal a single instance which parallels the case herein reported. Three features, each a most unusual sequel of tonsillectomy, are outstanding: ( a ) a markedly septic course with development of a heart murmur, ( b ) bloody stools and ( c ) gangrenous areas on both feet, involving the toes, followed by clinical recovery except for a residual systolic cardiac murmur and the loss of one toe. REPORT OF CASE History .—J. R., a girl, aged 2 years, 3 months, of Italian parentage, was admitted to the hospital for tonsillectomy and adenoidectomy on March 3, 1928. At that time the heart was of normal size and shape and murmurs were not heard; except for hypertrophied tonsils and adenoids the results of the physical examination were negative. The past history of the child was that of a normal, healthy child without previous illnesses, except for repeated attacks of