Accelerated Intravascular Coagulation in a Patient With Korean Hemorrhagic Fever

The injection of bacterial endotoxin into experimental animals causes accelerated consumption of blood clotting factors with thrombosis and hemorrhage.1It has been suggested that a similar phenomenon occurs in certain bacterial, viral, rickettsial, and parasitic infections in man.2Disseminated intravascular coagulation has been demonstrated in patients with pneumococcal, meningococcal, andPseudomonasbacteremias.3-5The characteristic coagulation defect responding to heparin sodium therapy has been reported inPlasmodium falciparummalaria and scrub typhus.6,7In a recent review, McKay and Margaretten8summarized the histopathologic evidence for the occurrence of disseminated intravascular coagulation in various exanthematous viral diseases and certain of the hemorrhagic fevers caused by arboviruses. The purpose of this report is to describe the coagulation abnormalities observed antemortem in a patient with Korean hemorrhagic fever (hemorrhagic nephroso-nephritis). Patient Summary A 23-year-old white soldier became ill 30 days after returning from military service in Korea. He was admitted