Microvascular thrombosis in sepsis: An autopsy study

Tani, Vanessa Miho; Assis‐Mendonça, Guilherme Rossi; Silva, Thamires Branco Da; Rogério, Fábio; Paula, Erich Vinícius De

doi:10.1016/j.thromres.2017.05.031

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…In sepsis there is an excessive systemic inflammatory response syndrome (SIRS), which can lead to multi-organ failure and the death of the patient (21). Sepsis is frequently associated with disseminated intravascular coagulation (DIC), a critical presentation of altered blood coagulation and microthrombus formation in the microvascular bed of different organs (6, 22, 23). The risk of thrombotic complications after infection is not limited to the hospital setting.…”

Section: Introductionmentioning

confidence: 99%

Understanding Infection-Induced Thrombosis: Lessons Learned From Animal Models

Beristain‐Covarrubias

et al. 2019

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Thrombosis is a common consequence of infection that is associated with poor patient outcome. Nevertheless, the mechanisms by which infection-associated thrombosis is induced, maintained and resolved are poorly understood, as is the contribution thrombosis makes to host control of infection and pathogen spread. The key difference between infection-associated thrombosis and thrombosis in other circumstances is a stronger inflammation-mediated component caused by the presence of the pathogen and its products. This inflammation triggers the activation of platelets, which may accompany damage to the endothelium, resulting in fibrin deposition and thrombus formation. This process is often referred to as thrombo-inflammation. Strikingly, despite its clinical importance and despite thrombi being induced to many different pathogens, it is still unclear whether the mechanisms underlying this process are conserved and how we can best understand this process. This review summarizes thrombosis in a variety of models, including single antigen models such as LPS, and infection models using viruses and bacteria. We provide a specific focus on Salmonella Typhimurium infection as a useful model to address all stages of thrombosis during infection. We highlight how this model has helped us identify how thrombosis can appear in different organs at different times and thrombi be detected for weeks after infection in one site, yet largely be resolved within 24 h in another. Furthermore, we discuss the observation that thrombi induced to Salmonella Typhimurium are largely devoid of bacteria. Finally, we discuss the value of different therapeutic approaches to target thrombosis, the potential importance of timing in their administration and the necessity to maintain normal hemostasis after treatment. Improvements in our understanding of these processes can be used to better target infection-mediated mechanisms of thrombosis.

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Section: Introductionmentioning

confidence: 99%

Understanding Infection-Induced Thrombosis: Lessons Learned From Animal Models

Beristain‐Covarrubias

et al. 2019

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“…Sepsis is an example of systemic inflammation with organ dysfunction, where disseminated intravascular coagulation has been observed as a major complication and cause of death. Coagulation activation and immunothrombosis have been considered hallmarks of sepsis [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Tuberculosis Presenting as Venous Thromboembolism

Shriwastav¹,

Agarwal²,

Shah³

et al. 2023

Cureus

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Tuberculosis (TB) is one of the leading causes of morbidity and mortality throughout the world and can have both pulmonary and extrapulmonary manifestations. Among the myriad extrapulmonary manifestations of TB, deep vein thrombosis (DVT) is rare. We present the case of a 25-year-old woman who presented with progressive painful swelling of the left upper limb associated with intermittent low-grade fever. Upon evaluation, she was found to have DVT along with a subsegmental pulmonary embolism. Further workup of the patient revealed bilateral pleural effusion and constrictive pericarditis along with microbiological evidence of Mycobacterium tuberculosis. The patient was started on anti-tubercular therapy along with therapeutic anti-coagulation, after which there was a substantial clinical improvement. Though rare, this case elucidates the venous thrombosis risk associated with one of the most common diseases in developing countries.

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“…Sepsis is an example of systemic inflammation with organ dysfunction where disseminated intravascular coagulation has been observed as a major complication and cause of death. The coagulation activation and immunothrombosis has been considered hallmarks of sepsis [7].…”

Section: Discussionmentioning

confidence: 99%