Muni Rubens, Venkataraghavan Ramamoorthy, Krimal Shah, Ashley Rodriguez, Brian Murillo, Karelis Lopez Muniz, Anshul Saxena, Peter McGranaghan, Tina Sanjar
Vasopressor-associated limb ischemia (VALI) is a rare but devastating complication of vasopressor therapy in septic shock. This case shows catastrophic four-limb amputation in a 26-year-old obese male with suspected septic shock. This case illustrates the complex interplay between prolonged high-dose vasopressor therapy, morbid obesity, and cytokine-mediated microvascular injury in VALI.