Objective This study was performed to evaluate the diagnostic value of the neutrophil CD64 index in patients with sepsis in the intensive care unit (ICU). Methods Patients with sepsis who were treated at the ICU of the authors’ institution from December 2016 to June 2018 were retrospectively reviewed. The controls comprised age- and sex-matched patients who underwent coronary bypass and had no evidence of infection. The neutrophil CD64 index, C-reactive protein (CRP) level, and procalcitonin level were compared between the two groups. The diagnostic performance of these measures, including the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve, was examined. Results In total, 35 patients with sepsis and 27 control patients were included in the data analysis. The sensitivity of the neutrophil CD64 index, CRP level, and procalcitonin level was 83%, 74%, and 77%, respectively. The specificity was 88%, 86%, and 81%, respectively. The area under the ROC curve was 0.923 [95% confidence interval (CI), 0.856–0.989], 0.904 (95% CI, 0.832–0.976), and 0.863 (95% CI, 0.776–0.950), respectively. Conclusion The neutrophil CD64 index is a valuable biomarker for diagnosing sepsis in patients in the ICU.

Iliopsoas hematoma is an uncommon clinical entity that may develop in association with anticoagulation states, coagulopathies and hemodialysis, or anticoagulant therapy. Here, we report a case of unilateral iliopsoas hematoma in a 60-year-old man who received low-molecular-weight heparin for anticoagulation due to continuous veno-venous hemofiltration. The patient presented with fever and productive cough for 2 days. He received continuous veno-venous hemofiltration due to rising blood urea nitrogen (22.7 mmol/L; normal references: 3.2–7.1 mmol) and creatinine (1345 µmol/L; normal references: 53–106 µmol/L). Low-molecular-weight heparin (enoxaparin, 3500–5500 Da, 5–10 IU/kg/h) was delivered continuously by pumps for anticoagulation therapy. At day 12 post heparin treatment, the patient complained left back pain. Platelet count (243 × 109/L) was normal, but both activated partial thromboplastin time (67.5 s) and prothrombin time (17.3 s) were prolonged. Abdominal computed tomography scan revealed left iliopsoas swelling with an indistinct border. Low-molecular-weight heparin was discontinued. Anti-Xa was not monitored throughout the treatment. No improvement was seen, and 3 days later, the patient died after his family decided to terminate therapy. This case highlights the needs for careful anticoagulation as well as close monitoring, and particularly the use of anti-Xa to guide the treatment.