ArticleOxford medical case reports2026
Severe Polyarticular gout mimicking sepsis after acute kidney injury: a case report.
Article in Oxford medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSevere gout flares may rarely present as systemic inflammatory syndromes, closely mimicking sepsis. Milk-of-urate bullae are an uncommon manifestation of extensive crystal burden and are typically described in chronic tophaceous gout. The combination of polyarticular involvement, extreme inflammatory markers, acute kidney injury (AKI), and bullous lesions represents a diagnostic challenge. CASE PRESENTATION: A 69-year-old man presented with generalized weakness and incapacitating migratory joint pain after lying on the floor for three days. Laboratory evaluation revealed acute prerenal kidney injury and a fulminant inflammatory response (CRP 47.7 mg/dl, leukocytes 16.8 × 10
conclusionThis case illustrates how severe polyarticular gout can mimic fulminant sepsis with extreme inflammatory markers and FDG-PET hypermetabolism. Acute kidney injury acted as a trigger for catastrophic crystal inflammation. Milk-of-urate bullae reflected extensive systemic urate burden. Recognition of this pattern is essential to avoid diagnostic delay and unnecessary antimicrobial therapy.
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