Acquired Factor VII Deficiency Presenting with Bleeding Diathesis in a 52-Year-Old Black Man in Botswana

Background: Factor VII is one of the vitamin K-dependent coagulation factors synthesized in the liver and has a short circulating half-life of 4 - 5 hours. Methods: We report a case of a 52-year-old black man who presented with life-threatening bleeding from multiple sites. Results: We determined that it was caused by acquired factor VII deficiency of less than 5%. He had a septic pelvic focus which was managed empirically with antibiotics. The bleeding was stopped by fresh frozen plasma and factor VII plasma levels gradually increased to normal levels over the course of 4 months. Conclusions: We emphasize the importance of extensive evaluation including septic, autoimmune, and malignant work-up in patients with new onset acquired bleeding.