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A Disease of the Past in the Present: From Trench Foot to Critical Care With Severe Non-freezing Cold Injury

Year: 2025

Type: article

Abstract: Non-freezing cold injury (NFCI), historically described as trench foot, is a rare but potentially life-threatening condition resulting from prolonged exposure to cold, wet environments at near-freezing temperatures. We present the case of a previously healthy 21-year-old man found partially submerged for three days, who developed profound hypothermia, shock, altered consciousness, and extensive soft tissue compromise. Laboratory evaluation revealed multiorgan dysfunction, and brain computed tomography (CT) demonstrated diffuse cerebral edema. Blood cultures became positive within seven hours, isolating Aeromonas hydrophila and Pseudomonas species, confirming fulminant Gram-negative bacteremia secondary to soft tissue infection. After a period of intensive supportive care, the patient improved clinically and was transferred to a burn unit for surgical management. This case highlights that NFCI is not confined to historical military contexts but remains a relevant contemporary clinical challenge. Early recognition, aggressive supportive care, and timely surgical intervention are crucial to improving survival, limiting sepsis progression, reducing tissue loss, and preventing long-term disability.

Source: Cureus

DOI: 10.7759/cureus.96139

Authors: Nuno Prucha Leite, David Costa, Marta Rebocho Alves, João Abranches Carvalho, Luís Teles

Institution: Unidade Local de Saúde de Entre Douro e Vouga

Language: English

Topic: Thermal Regulation in Medicine

Subfield: Critical Care and Intensive Care Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415924933