Severe Acquired Coagulopathy During Fulminant Sepsis Most Likely Caused by Exotoxins (SSLs).

UNLABELLED

Haemostatic abnormalities frequently occur during sepsis and are most often attributed to disseminated intravascular coagulation (DIC). We report the case of a patient with severe coagulopathy acquired during fulminant sepsis. DIC was not present. This coagulopathy was most likely caused by exotoxins forming inhibitory complexes with coagulation factor Xa.

LEARNING POINTS

To our knowledge, this is the first report describing inhibition of coagulation by in vivo and so will hopefully broaden our knowledge of sepsis, exotoxins and coagulation disorders during sepsis.While disseminated intravascular coagulation (DIC) is the most frequent severe coagulopathy diagnosed during sepsis, inhibition of coagulation by SSL10 may be an underdiagnosed cause during sepsis.As DIC and inhibition of coagulation by SSL10 should be treated differently, we emphasize the importance of considering inhibition of blood coagulation by when an acquired coagulopathy is found during severe sepsis.