The patient was admitted to ICU for septic shock (possible foci: abdominal and dog bite) complicated with hemorrhagic shock of iatrogenic origin. Emergency femoral lines/punctures were performed. Hemodynamic instability with the need for norepinephrine and dobutamine and severe sepsis with PCT>100 developed.

The patient eventually died of multiorgan failure.

Renal cortical necrosis is a rare form of acute renal failure characterized by ischemic destruction of all the elements of the renal cortex from significantly diminished renal arterial perfusion. In contrast-enhanced computed tomography it results in non-enhancement of the renal cortex in contrast to adequately enhancing renal medullae mimicking a retrograde renography. This CT finding (reverse rim sign) is diagnostic for renal cortical necrosis and usually results in permanent kidney injury.