A Case Report of a Patient With Renal Artery Thrombosis Despite Being on Treatment Dose of Direct Oral Anticoagulant

Renal artery thrombosis is a rare but serious cause of acute abdominal pain, which can rapidly progress to renal infarction. It is difficult to diagnose as it is very rare and can present in a similar manner to other causes of abdominal pain. We present the case of a 76-year-old man who developed right renal artery thrombosis leading to a renal infarction in addition to a splenic infarct. This happened despite being on a treatment dose of a direct oral anticoagulant (DOAC) in the presence of Staphylococcus haemolyticus bacteremia. Despite medical management including therapeutic anticoagulation, intravenous (IV) antibiotics and IV fluids, his condition deteriorated, and he died due to S. haemolyticus sepsis. This case highlights the complex interaction between sepsis, atherosclerosis, thrombosis and the diagnostic challenges posed by such a rare condition.