Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

28 May 2015 : Case report  Japan

A Case of Severe Sepsis Presenting Marked Decrease of Neutrophils and Interesting Findings on Dynamic CT

Unusual clinical course

Isamu MakinoBCDEF, Hidehiro TajimaCD, Hirohisa KitagawaBCD, Hisatoshi NakagawaraCD, Tomoharu MiyashitaCD, Shinichi NakanumaCD, Hironori HayashiCD, Hiroyuki TakamuraCD, Sachio FushidaCD, Tetsuo OhtaCDE

DOI: 10.12659/AJCR.893351

Am J Case Rep 2015; 16:322-327

Abstract

BACKGROUND: In a patient with severe sepsis, we sometimes observe immediate decrease of the counts of white blood cells (WBCs) and neutrophils, which is known as an indicator for poor prognosis. We observed marked decrease of white blood cells and neutrophils on blood examination and interesting findings on dynamic CT. Here, we present the case of a patient with severe postoperative sepsis occurring after major abdominal surgery and we discuss the mechanism of such clinical presentations.

CASE REPORT: A 60-year-old man received pancreatoduodenectomy with colectomy for pancreatic cancer. He developed a high fever on postoperative day 3. We observed marked decrease of WBCs and neutrophils on blood examination. We also observed slight swelling of the liver, inhomogeneous enhancement of liver parenchyma in arterial phase, and periportal low density in the Glisson capsule in portal phase, without any findings indicating infectious complications on dynamic CT. WBCs and neutrophils increased above normal range in just 6 hours. Blood culture examination performed while the patient had a high fever was positive for Aeromonas hydrophila. After receiving intensive care, he promptly recovered from severe sepsis. The CT findings disappeared on second dynamic CT examination performed 3 days after the first examination.

CONCLUSIONS: We treated a patient with severe sepsis after major abdominal surgery who presented very rapid change of the counts of WBCs and neutrophils and interesting CT findings in the liver. We rescued him from a critical situation by prompt and intensive treatment. Research is needed to accumulate and analyze data from more patients who present a similar clinical course to better understand their pathophysiological conditions.

Keywords: Leukocyte Count, Neutrophils - pathology, Pancreatectomy - adverse effects, Positron-Emission Tomography, Sepsis - diagnosis, Surgical Wound Infection - diagnosis, Tomography, X-Ray Computed

Add Comment 0 Comments

In Press

30 Jan 2024 : Case report  Colombia

Bedside Ultrasound to Guide the Diagnosis and Treatment of Fulminant Right Heart Failure: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.942694  

0:00

01 Feb 2024 : Case report  Vietnam

Conservative versus Surgical Treatment of Pneumatosis Intestinalis: Experience from a Multidisciplinary Center

Am J Case Rep In Press; DOI: 10.12659/AJCR.943166  

08 Feb 2024 : Case report  Indonesia

Right Thigh Mass Metastasis from Lung Cancer Mimicking Primary Soft Tissue Sarcoma: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.942416  

05 Feb 2024 : Case report  USA

Unraveling the Uncommon: A Case Report of Giant Cell Myocarditis and Examination of Existing Literature

Am J Case Rep In Press; DOI: 10.12659/AJCR.942381  

Most Viewed Current Articles

10 Jan 2022 : Case report  Germany

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

19 Jul 2022 : Case report  Saudi Arabia

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

05 Mar 2022 : Case report  Brazil

Acute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...

DOI :10.12659/AJCR.935336

Am J Case Rep 2022; 23:e935336

02 Apr 2022 : Case report  Saudi Arabia

Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Li...

DOI :10.12659/AJCR.935743

Am J Case Rep 2022; 23:e935743

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923