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Unusual cause of severe diabetic ketoacidosis precipitated by Streptococcus bovis/equinus (SBSEC) bacteremia: Case report and review of literature

机译:牛链球菌/马尿(SBSEC)菌血症促成严重糖尿病酮症酸中毒的异常原因:病例报告和文献复习

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摘要

Diabetic ketoacidosis is a feared complication in patients with diabetes mellitus and poses high risk of mortality and morbidity unless treated in timely manner. Infection is one of the most common precipitating factors for the development of diabetic ketoacidosis. Bacteremia with Group A and Group B beta hemolytic streptococcal strains are well known, however nonenterococcal Group D strains such as the Streptococcus bovis/Streptococcus equinus complex (SBSEC) still remains an understudied entity. Here we present a case of a 35-year-old Type I diabetic female presenting with severe diabetic ketoacidosis with overlapping features of hyperosmolar hyperglycemia, precipitated by Streptococcus alactolyticus bacteremia, successfully treated with four-week course of parenteral ceftriaxone. This case report emphasizes the potential importance of SBSEC as an emerging pathologic strain and culprit for triggering diabetic ketoacidosis which requires prompt diagnosis and targeted therapy.
机译:糖尿病酮症酸中毒是糖尿病患者令人担忧的并发症,除非及时治疗,否则会带来很高的死亡和发病率风险。感染是糖尿病酮症酸中毒发展的最常见诱因之一。具有A组和B组β溶血性链球菌菌株的细菌血症是众所周知的,但是非肠球菌D组菌株,例如牛链球菌/马链球菌复合物(SBSEC)仍然是一个研究不足的实体。在这里,我们介绍了一名35岁的I型糖尿病女性患者,该患者患有严重的糖尿病酮症酸中毒,并伴有高渗性高血糖重叠特征,并由解链球菌菌血症引起,成功地接受了为期四周的肠胃外头孢曲松治疗。该病例报告强调了SBSEC作为引发糖尿病性酮症酸中毒的新兴病理菌株和元凶的潜在重要性,这需要迅速诊断和靶向治疗。

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