Abstract
BackgroundSepsis 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.Case presentationA 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.ConclusionsEarly identification, intensive monitoring, and aggressive support may reduce the acquired thrombotic risk and avoid potentially life-threatening outcomes of sepsis.
Highlights
Sepsis is a syndrome of life-threatening organ dysfunction caused by a dysregulated host response to infection
Case presentation A 49-year-old white woman re-presented to hospital with a history suggestive of sepsis
This report describes a patient with bilateral adrenal hemorrhage following a recent admission with Escherichia coli sepsis
Summary
Bilateral adrenal hemorrhage is a rare cause of primary adrenal insufficiency. The risk is likely to be heightened in patients at increased risk of thrombophilia, such as those with APS, especially when a severe infection intervenes. This case highlights the serious secondary consequences of sepsis, which should be considered in high-risk patients. Identification, monitoring, and management of sepsis may reduce this acquired thrombotic risk and avoid potentially life-threatening outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
