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 …