Sepsis Caused by Colonic Diverticulitis with no Abdominal Signs and Symptoms: Report of a Case

Abstract

A 62-year-old male with disturbance of consciousness was transferred to our emergency room. On arrival, his Glasgow coma scale was 10 points, heart rate was 140 beats/min, respiratory rate was 30 breaths/min, and temperature was 40.8℃. In the laboratory tests the values of CRP (20.6 mg/dL) and PCT (25.46 ng/mL) were elevated. No abdominal signs and symptoms were observed at the first medical examination. His abdominal computed tomography showed multiple diverticula in his ascending colon and the elevation of fatty density around the diverticula, suggesting colonic diverticulitis. Klebsiella pneumonia and Bacillus spp. were revealed in his blood culture performed on his arrival. After treatment including antibiotic therapy and intensive care, his condition recovered, and he was discharged on the 13th hospital day. No abdominal signs and symptoms were observed throughout his clinical course. Diverticulitis with no abdominal signs and symptoms can be a cause of sepsis, and we should take diverticulitis into account as a differential diagnosis when there is a patient with sepsis of unknown origin.