In critically ill patients, disseminated intravascular coagulation (DIC) is a common and fatal hematological disorder. DIC is a physiological response to a variety of underlying stimuli that provoke generalized activation of the hemostatic mechanism and is common in septic patients and those with hematological or non-hematological malignant neoplasms. Bleeding is a common clinical feature, and diffuse or multiple-site mucocutaneous bleeding, such as petechia, ecchymosis and hemorrhage from gastrointestinal tract, is often seen. A 58-year-old male was recently diagnosed with intracranial hemorrhage (ICH) caused by DIC associated with sepsis. Mortality of ICH caused by DIC is very high because the underlying condition cannot be quickly treated. Awareness of the possibility of DIC developing in a critically ill patient and the need for immediate initiation of plasma or platelet replacement therapy are important. To the best of our knowledge, this is the first reported case of intracranial hemorrhage in a Korean patient with DIC associated with sepsis.
Blood Platelets ; Critical Illness ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Ecchymosis ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intracranial Hemorrhages* ; Male ; Middle Aged ; Mortality ; Plasma ; Sepsis*

Pulmonary artery pseudoaneurysm (PAP) is a very rare vascular abnormality and is often caused at least in part by infection. While Mycobacterium tuberculosis is a relatively common cause of PAP, it can also result from a lung abscess. Aneurysm rupture resulting in massive hemoptysis is potentially fatal, with death caused by aspiration of blood and consequent asphyxiation. We admitted a 55-year-old man with massive hemoptysis. He had been treated with intravenous antibiotics for three weeks after diagnosing a lung abscess. Contrast-enhanced chest computed tomography revealed a pseudoaneurysm inside the abscess. Diagnostic catheter pulmonary angiography confirmed the diagnosis of pseudoaneurysm of the pulmonary artery. Embolization successfully controlled the airway bleeding. However, the patient died of acute respiratory failure on the seventh hospital day. When hemoptysis is due to sustained inflammation, such as a lung abscess, bleeding from the pulmonary artery should be considered.
Abscess ; Aneurysm ; Aneurysm, False* ; Angiography ; Anti-Bacterial Agents ; Catheters ; Diagnosis ; Hemoptysis* ; Hemorrhage ; Humans ; Inflammation ; Lung Abscess* ; Lung* ; Middle Aged ; Mycobacterium tuberculosis ; Pulmonary Artery* ; Respiratory Insufficiency ; Rupture ; Thorax

In critically ill patients, disseminated intravascular coagulation (DIC) is a common and fatal hematological disorder. DIC is a physiological response to a variety of underlying stimuli that provoke generalized activation of the hemostatic mechanism and is common in septic patients and those with hematological or non-hematological malignant neoplasms. Bleeding is a common clinical feature, and diffuse or multiple-site mucocutaneous bleeding, such as petechia, ecchymosis and hemorrhage from gastrointestinal tract, is often seen. A 58-year-old male was recently diagnosed with intracranial hemorrhage (ICH) caused by DIC associated with sepsis. Mortality of ICH caused by DIC is very high because the underlying condition cannot be quickly treated. Awareness of the possibility of DIC developing in a critically ill patient and the need for immediate initiation of plasma or platelet replacement therapy are important. To the best of our knowledge, this is the first reported case of intracranial hemorrhage in a Korean patient with DIC associated with sepsis.
Blood Platelets ; Critical Illness ; Dacarbazine ; Disseminated Intravascular Coagulation ; Ecchymosis ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Male ; Middle Aged ; Mortality ; Plasma ; Sepsis