LAUSR

We present a case of a 53-year-old woman who presented to the emergency room with acute abdominal pain, fever and haemodynamic and respiratory instability and was admitted to the intensive care unit with fulminant septic shock with multiorgan failure. CT imaging of the abdomen showed no gross abnormalities, initial laboratory results are presented in table 1. View this table: Table 1 Laboratory test results Despite adequate resuscitation, broad-spectrum antibiotics and supportive care, following the International Guidelines of the Surviving Sepsis Campaign, she died within a couple of hours. The patient had a history of systemic lupus erythematosus (SLE) with arthralgia, positive antinuclear antibodies and persistently high anti-DNA antibodies, but without active disease and no immunosuppressive medication since years. Leucocyte typing of the initial peripheral blood smear showed Howell-Jolly bodies and diplococci, indicating massive …