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    A 14-year-old girl presented to the emergency room with loss of consciousness for 7 hours preceded by epigastric pain, nausea, headache, and fever. She had a 1-week history of toothache and symptoms of polydipsia, polyuria, and polyphagia over several months. Physical examination revealed kussmaul breathing and sopor. Laboratory findings confirmed diabetic ketoacidosis with a blood glucose of 850 mg/dL, pH of 7.15, HCO3 of 9.6 mmol/L, and urinary ketones. She was diagnosed with type 1 diabetes triggered by infection and treated with fluid resuscitation, rapid insulin, antibiotics, and close monitoring in the ICU.

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    A 14-year-old girl presented to the emergency room with loss of consciousness for 7 hours preceded by epigastric pain, nausea, headache, and fever. She had a 1-week history of toothache and symptoms of polydipsia, polyuria, and polyphagia over several months. Physical examination revealed kussmaul breathing and sopor. Laboratory findings confirmed diabetic ketoacidosis with a blood glucose of 850 mg/dL, pH of 7.15, HCO3 of 9.6 mmol/L, and urinary ketones. She was diagnosed with type 1 diabetes triggered by infection and treated with fluid resuscitation, rapid insulin, antibiotics, and close monitoring in the ICU.

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    53 views5 pages

    Diabetic Ketoacidosis Triggered by Infection in

    Uploaded by

    patricx10
    A 14-year-old girl presented to the emergency room with loss of consciousness for 7 hours preceded by epigastric pain, nausea, headache, and fever. She had a 1-week history of toothache and symptoms of polydipsia, polyuria, and polyphagia over several months. Physical examination revealed kussmaul breathing and sopor. Laboratory findings confirmed diabetic ketoacidosis with a blood glucose of 850 mg/dL, pH of 7.15, HCO3 of 9.6 mmol/L, and urinary ketones. She was diagnosed with type 1 diabetes triggered by infection and treated with fluid resuscitation, rapid insulin, antibiotics, and close monitoring in the ICU.

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    of 5

    DIABETIC KETOACIDOSIS TRIGGERED

    BY INFECTION IN 14 YEARS OLD GIRL : A


    CASE REPORT

    Patrick Ramos Pakpahan, Gabriella Berta Risma


    Departement Of Child Health, Mardi Waluyo General Hospital, Metro,
    Lampung
    BACKGROUND
    DIABETIC KETOACIDOSIS (DKA) IS AN ACUTE COMPLICATION IN
    CHILDREN WITH DIABETES MELLITUS (DM). INFECTIOUS DISEASE IS
    COMMON RISK FACTOR IN MANY CASES.
    OBJECTIVE

    TO LEARN HOW TO DIAGNOSE AND MANAGEMENT OF DKA IN


    EMERCENCY AT GENERAL HOSPITAL
    CASE
    A female child, 14 year 7 Patient was given initial
    month, body weight 36 kg Physical examination found
    treatment with fluid
    patient soporocomatous
    came into emergency room resuscitation 1500cc
    with kussmaul breathing.
    with lost of consciousness NaCl in 1 hour, rapid
    white blood cell count
    insulin, Ringer lactat mix
    for 7 hours. Before that she 23.500/mm3, blood glucose
    with KCl and antibiotic.
    felt epigastric pain, nausea, level 850 g/dl, pH=7,15,
    Patient admitted to ICU,
    headache, and fever. She HCO3=9,6 mmHg, urinary
    and after 24 hours
    ketone +1, Hba1C > 14%,
    lost of weight in several patient condition was
    and C-peptide 0,6 ng/ml.
    month, polydipsia, polyuria better. For further
    Patient diagnose with DKA
    treatment patient was
    and polyphagia (triad of with type 1 diabetes.
    given subcutan insulin.
    diabetic). She felt toothache
    for about 1 week.

    Keywords : diabetes mellitus, infection, ketoacidosis


    CONCLUSION
    THERE MUST BE AWARENESS AMONG PARENTS AND FIRST CARE DOCTOR FOR
    DIABETES MELLITUS IN CHILDREN, THERE FOR DECREASE RISK OF DKA DUE TO
    EARLY DIAGNOSTIC. INFECTION IS A FACTOR THAT WE SHOULD NOT FORGET AS A
    PREDISPOSITION TO THE OCCURRENCE OF DKA WHEN MEETING WITH CHILD
    WHO HAVE DKA. INITIAL THERAPY IN DKA HAS IMPORTANT ROLE FOR OUTCOME
    AND ANY COMPLICATIONS.

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