Symmetrical peripheral gangrene and disseminated intravascular coagulation associated with pelvi-ureteric junction obstruction
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
- Correspondence to Dr Victoria Louise Reid, victoria.reid{at}nhs.net
Description
An 87-year-old woman presented to the emergency department with confusion, sinus tachycardia, hypotension and fever. Laboratory investigations confirmed metabolic acidosis, acute kidney injury (urea 18.5 mmol/l, serum creatinine 197 µmol/l and Egfr 21 ml/min/1.73 m2), depressed bone marrow function (platelets 136×109/l and white cell count (WCC) 3.0×109/l) and elevated prothrombin and activated partial thromboplastin time (PT 15.8 s and APTT 61 s). Urinalysis was positive for blood, protein and leucocytes. Severe sepsis was diagnosed …
