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Disseminated Intravascular Coagulation

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Evidence-Based Critical Care

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Abstract

A 64-year old woman with a history of non-small cell lung cancer, Type 2 diabetes, and hypertension presented to the emergency department with altered mental status and flank pain. In the emergency department, her initial blood pressure was 83/44 mmHg, with a pulse of 110 beats per minute. On physical examination, she was somnolent but arousable. She had a fine petechial rash on both lower extremities and bleeding from her peripheral IV sites. Laboratory testing results included: white blood cell count of 3100/μL, creatinine of 2.5 mg/dL (her baseline being 1.0), International Normalized Ratio (INR) of 3.1, Partial Thromboplastin Time of 50 s, and platelet count of 33,000 cells/μL. The urine microscopy revealed 20–50 WBC/high-powered field; the urine culture is growing 100,000 colony-forming units of a gram negative bacillus. A computerized tomography (CT) scan of the abdomen and pelvis revealed left hydronephrosis, hydroureter, and perinephric stranding. A slide of the patient’s peripheral blood smear is shown in the Fig. 78.1.

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Authors and Affiliations

  1. Department of Medicine, Westchester Medical Center, Valhalla, NY, USA

    Mario V. Fusaro

  2. Division of Pulmonary and Critical Care Medicine, Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD, USA

    Giora Netzer

Authors
  1. Mario V. Fusaro
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  2. Giora Netzer
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Correspondence to Giora Netzer .

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Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Fusaro, M.V., Netzer, G. (2020). Disseminated Intravascular Coagulation. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_78

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_78

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