Diabetic Ketoacidosis and Acute Coronary Syndrome Due to Neck Abscess

Main Article Content

Nurhasan Agung Prabowo Hana Indriyah Dewi Adhizti Naluriannisa Edya Nugraha Tonang Dwi Ardyanto

Abstract

Diabetic ketoacidosis (DKA) is a life-threatening consequence of diabetes mellitus. Infection is the most common cause of DKA. A 41-year-old man came to the hospital emergency department with shortness of breath the day before, nausea, vomiting, coughing, pain and swelling in the left neck. The patient has a history of uncontrolled diabetes. A physical examination revealed Kussmaul's breathing and a lump the size of a tennis ball on the left side of his neck. Laboratory findings are: leukocytosis, an increase in blood sugar of 512 mg/dL; blood gas analysis shows acidosis, ketone examination reveals ketonuria; Electrocardiography shows waves of ischemic heart disease, with elevated Hs Troponin. Fine needle examination of the lump shows a neck abscess. The patient was diagnosed with DKA in type 2 diabetes mellitus, with the acute coronary syndrome and neck abscess. Surgical debridement, antibiotics, acute coronary syndrome therapy, and DKA therapy are treatments. The patient responded well to treatment.


 

Article Details

How to Cite
PRABOWO, Nurhasan Agung et al. Diabetic Ketoacidosis and Acute Coronary Syndrome Due to Neck Abscess. Medical Research Archives, [S.l.], v. 10, n. 7, july 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2896>. Date accessed: 03 dec. 2022. doi: https://doi.org/10.18103/mra.v10i7.2896.
Section
Case Reports

References

1. Prabowo NA, Ardyanto TD, Hanafi M, et al. Peningkatan Pengetahuan Diet Diabetes, Self Management diabetes dan Penurunan Tingkat Stres Menjalani Diet pada Pasien Diabetes Mellitus Tipe 2 di Rumah Sakit Universitas Sebelas Maret. warta. 2021;24(2):285-296. doi:10.23917/warta.v24i2.12515
2. Sholihah MM, Kusuma TRH, Hanif MI, Prabowo NA. Letter to the Editor on Type 1 diabetes onset triggered by COVID-19. Acta Diabetol. 2021;58(9):1283-1284. doi:10.1007/s00592-021-01761-3
3. Shizuma T, Fukui S, Todoroki K. A Case of Back Abscess and Diabetic Ketoacidosis in a Patient with Type 2 Diabetes Mellitus. Diabetes Case Reports. 2017;01(02):2-4. doi:10.4172/2572-5629.1000106
4. Bandyopadhyay D, Devanabanda AR, Tummala R, et al. Effect of diabetic ketoacidosis on the outcomes of ST-elevation myocardial infarction: An analysis of national inpatient sample. IJC Heart and Vasculature. 2019;24:100384. doi:10.1016/j.ijcha.2019.100384
5. Corrales-Medina VF, Madjid M, Musher DM. Role of acute infection in triggering acute coronary syndromes. The Lancet Infectious Diseases. 2010;10(2):83-92. doi:10.1016/S1473-3099(09)70331-7
6. Kaefer K, Botta I, Mugisha A, et al. Acute coronary syndrome and diabetic keto acidosis: the chicken or the egg? Annals of Translational Medicine. 2019;7(16):397-397. doi:10.21037/atm.2019.07.38
7. Kadel A, Thakur KK, Rauniyar BK, Adhikari RB, Limbu D, Malla R. Acute Myocardial Infarction and Diabetic Ketoacidosis: The Lethal Duo. J Nepal Health Res Counc. 2021;19(1):212-214. doi:10.33314/jnhrc.v19i1.3193
8. Bhatia M, Fei LW, Cao Y, et al. Pathophysiology of acute pancreatitis. Pancreatology. 2005;5(2-3):132-144. doi:10.1159/000085265
9. Guisado-Vasco P, Cano-Megías M, Carrasco-de la Fuente M, Corres-González J, Matei AM, González-Albarrán O. Clinical features, mortality, hospital admission, and length of stay of a cohort of adult patients with diabetic ketoacidosis attending the emergency room of a tertiary hospital in Spain. Endocrinologia y Nutricion. 2015;62(6):277-284. doi:10.1016/j.endonu.2015.02.003
10. Draman MS, Thabit H, Kiernan TJ, O’Neill J, Sreenan S, McDermott JH. A silent myocardial infarction in the diabetes outpatient clinic: case report and review of the literature. Endocrinology, Diabetes & Metabolism Case Reports. 2013;2013(October). doi:10.1530/edm-13-0058
11. Issa M, Alqahtani F, Ziada KM, et al. Incidence and Outcomes of Non-ST Elevation Myocardial Infarction in Patients Hospitalized with Decompensated Diabetes. American Journal of Cardiology. 2018;122(8):1297-1302. doi:10.1016/j.amjcard.2018.07.004
12. Dokter P, Kardiovaskular S, Ketiga E. Pedoman Tatalaksana Sindrom Koroner Akut Edisi Ketiga. Published online 2015.