Back to Search Start Over

Bilateral adrenal hemorrhage in the background of Escherichia coli sepsis: a case report.

Authors :
Khwaja J
Source :
Journal of medical case reports [J Med Case Rep] 2017 Mar 17; Vol. 11 (1), pp. 72. Date of Electronic Publication: 2017 Mar 17.
Publication Year :
2017

Abstract

Background: Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host response to infection. It can have devastating consequences, including bilateral adrenal hemorrhage, particularly in patients at high thrombotic risk, such as those with antiphospholipid syndrome and those on long-term anticoagulation.<br />Case Presentation: A 49-year-old white woman re-presented to hospital with a history suggestive of sepsis. She had a medical background of primary antiphospholipid syndrome on lifelong warfarin. Ten days prior to this presentation, she had been hospitalized following Escherichia coli bacteremia, commenced on intravenous antibiotics, and discharged 2 days later with a prescribed 5-day course of oral amoxicillin. On readmission, she had ongoing fever, myalgia, malaise, and hypotension. Investigations revealed anemia with thrombocytopenia, hyponatremia, and acute-on-chronic kidney injury. Despite treatment for urosepsis, she became tachypneic, clammy, light-headed, drowsy, and hypothermic. Computed tomography revealed bilateral adrenal hemorrhage, and biochemical examination confirmed hypoadrenalism. Following discharge, she had persistent renal and hepatic injury lasting 3 months.<br />Conclusions: Early identification, intensive monitoring, and aggressive support may reduce the acquired thrombotic risk and avoid potentially life-threatening outcomes of sepsis.

Details

Language :
English
ISSN :
1752-1947
Volume :
11
Issue :
1
Database :
MEDLINE
Journal :
Journal of medical case reports
Publication Type :
Academic Journal
Accession number :
28302165
Full Text :
https://doi.org/10.1186/s13256-017-1236-0