[Multi-organ failures during septic shock from Escherichia coli urinary tract infection: catastrophic antiphospholipid syndrome?].
BACKGROUND
Although the presence of antiphospholipid antibodies is not an uncommon fact during infection, their responsibility in serious manifestations can still be debated and questions the existence of an actual catastrophic antiphospholipid syndrome or multivisceral faintings, triggered by the infection only, since the presence of antiphospholipid antibodies is not pathogenous.


METHODS
A 68-year-old man presented during an Escherichia coli urinary tract infection a septic shock with renal and cardiac insufficiencies, hepatic cytolysis and cholestasis and disseminated intravascular coagulation. There was a significant titer of antiphospholipid antibodies IgG (50 UGPL/ml) with an antibêta2-glycoprotein-1 positivity. The patient quickly recovered with antibiotherapy and intravenous immunoglobulins.


CONCLUSIONS
Diagnosing the pathogeny of multivisceral faintings is founded of the clinical manifestations published during the catastrophic antiphospholipid syndrome, the evolution and the persistence of post recovery antibodies and the comparison with the visceral bouts that the sepsis exclusively as revealed.
Graffin
B
B
Service de médecine interne, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83800 Toulon Naval, France. graffinbruno@noos.fr
Goutorbe
P
P
Poyet
R
R
Raymond
A
A
Paris
J-F
JF
Carli
P
P
D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications*; D002388:Catastrophic Illness; D004927:Escherichia coli Infections / Q000150:complications*; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology*; D012772:Shock, Septic / Q000150:complications*; D014552:Urinary Tract Infections / Q000150:complications*