The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Diabetic Ketoacidosis Precipitated by Klebsiella Liver Abscess and Brain Abscess

Klebsiella 간농양과 지연 발현된 뇌농양으로 유발된 당뇨병케톤산증

  • Kim, Dong-Soon (Department of Internal Medicine, Eulji University Hospital) ;
  • Kim, Hyun-Jin (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Park, Kang-Seo (Department of Internal Medicine, Eulji University Hospital) ;
  • Lee, Seong-Gyu (Department of Internal Medicine, Eulji University Hospital) ;
  • Lee, Jae-Hyuk (Department of Internal Medicine, Eulji University Hospital) ;
  • Ko, Bong-Suk (Department of Internal Medicine, Eulji University Hospital) ;
  • Moon, Hyun-Jin (Department of Internal Medicine, Eulji University Hospital)
  • 김동순 (을지대학교 의과대학 내과학교실) ;
  • 김현진 (충남대학교 의과대학 내과학교실) ;
  • 박강서 (을지대학교 의과대학 내과학교실) ;
  • 이성규 (을지대학교 의과대학 내과학교실) ;
  • 이재혁 (을지대학교 의과대학 내과학교실) ;
  • 고봉석 (을지대학교 의과대학 내과학교실) ;
  • 문현진 (을지대학교 의과대학 내과학교실)
  • Published : 2011.11.01
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Abstract

Diabetes mellitus is a known risk factor for Klebsiella pneumoniae liver abscess, and may be associated with metastatic complications. We report a case of diabetic ketoacidosis (DKA) precipitated by a K. pneumoniae liver abscess and followed by a brain abscess. A 31-year-old man with uncontrolled type 2 diabetes was admitted for DKA. Abdominal and pelvic computed tomography scans showed multiple abscesses in the lung, liver, both kidneys, and prostate gland. The blood culture yielded K. pneumoniae. The patient's condition improved following antibiotic and insulin therapy, and he was discharged. However, he was rehospitalized 10 days after discharge due to a generalized tonic-clonic seizure. Brain magnetic resonance imaging revealed a brain abscess in the right basal ganglia. The patient was given an intravenous injection of antibiotics (vancomycin and carbapenem), and he recovered well with no neurological sequelae.

저자들은 잘 조절되지 않는 제2형 당뇨병이 있던 31세 남자 환자가 상복부 불편감을 주소로 내원하여 혈역학적 검사와 영상의학 검사를 통해 간농양을 포함한 복강내 다발성 농양으로 유발된 당뇨병 케톤산증을 진단받았으며 이후 지연성 혈행성 전이로 뇌농양이 발생한 증례를 경험하여 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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