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 <i>Staphylococcus haemolyticus</i> bacteremia. Despite medical management including therapeutic anticoagulation, intravenous (IV) antibiotics and IV fluids, his condition deteriorated, and he died due to <i>S. haemolyticus</i> sepsis. This case highlights the complex interaction between sepsis, atherosclerosis, thrombosis and the diagnostic challenges posed by such a rare condition.