Case Report: Severe Frostbite in Extreme Altitude Climbers—The Kathmandu Iloprost Experience Prativa Pandey, MD, Ravi Vadlamudi, MD, MPH, Rashila Pradhan,

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Presentation transcript:

Case Report: Severe Frostbite in Extreme Altitude Climbers—The Kathmandu Iloprost Experience Prativa Pandey, MD, Ravi Vadlamudi, MD, MPH, Rashila Pradhan, MDGP, Kishore R. Pandey, MRCP, Alex Kumar, MBBS, Peter Hackett, MD Wilderness & Environmental Medicine Volume 29, Issue 3, Pages 366-374 (September 2018) DOI: 10.1016/j.wem.2018.03.003 Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 1 Frostbite of both feet, with purplish discoloration involving all toes and extending to mid-metatarsals, with hemorrhagic blisters on toes. Photos: top row at 74 h; bottom row, left and middle photos at 3 mo, right at 1 y. (See text.). Wilderness & Environmental Medicine 2018 29, 366-374DOI: (10.1016/j.wem.2018.03.003) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 2 Patient 1. Grade 3 frostbite of both great toes and second toe of the right foot, grade 2 of third, fourth, and fifth toes of left foot and third toe of right foot. Photos: top row at 48-72 h; bottom row at 3 mo and 16 mo. Wilderness & Environmental Medicine 2018 29, 366-374DOI: (10.1016/j.wem.2018.03.003) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 3 Patient 2. Grade 3 frostbite of both great toes and right second toe, and grade 2 of third, fourth, and fifth toes of the right foot and fourth toe of left foot. Photos: top left, 32-48 h; top right, 1 mo; bottom row, 3 mo. Wilderness & Environmental Medicine 2018 29, 366-374DOI: (10.1016/j.wem.2018.03.003) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 4 Patient 3. Grade 3 frostbite of digits 4 and 5 of the right hand and digit 4 of the left, with grade 2 of third digits of both hands. Photos: top row, at 60 h; bottom row, at 2 mo and 1 y. Wilderness & Environmental Medicine 2018 29, 366-374DOI: (10.1016/j.wem.2018.03.003) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 5 Patient 4. Grade 3 frostbite of all toes of the right foot. Photos: top row, at 72 h and 6 d (day 3 of iloprost infusion) bottom row, 1 mo and 3 mo. Wilderness & Environmental Medicine 2018 29, 366-374DOI: (10.1016/j.wem.2018.03.003) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 6 Patient 5. Grade 4 frostbite of right great toe with grade 3 of others. Photos: top row at 66 h, bottom row 3 mo and 6 mo. Wilderness & Environmental Medicine 2018 29, 366-374DOI: (10.1016/j.wem.2018.03.003) Copyright © 2018 Wilderness Medical Society Terms and Conditions