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A 71-year-old man with hyperglycemia and mental status changes
Christopher Naquin1, Malini Kumar, Harry Chen
1Louisiana State University Health Sciences Center, Family Practice Residency Program, New Orleans, USA.
Summary
Hyperglycemic hyperosmolar syndrome, a severe diabetes complication, is diagnosed by identifying its cause. This case highlights multiple potential infections like pharyngitis, UTIs, and endocarditis as triggers.
Area of Science:
- Endocrinology
- Infectious Diseases
- Critical Care Medicine
Background:
- Hyperglycemic hyperosmolar syndrome (HHS) is a serious complication of uncontrolled diabetes mellitus.
- While diagnosis of HHS is typically straightforward, identifying the precipitating cause can be complex.
- Infections are common triggers, but other stressors may also be involved.
Observation:
- This report details a patient who presented with hyperglycemic hyperosmolar coma.
- The patient exhibited symptoms suggestive of three distinct potential precipitating infections.
- These included pharyngitis, urinary tract infection, and infective endocarditis.
Findings:
- The case underscores the diagnostic challenge in pinpointing the exact cause of HHS.
- Multiple concurrent infections can complicate the presentation of hyperglycemic hyperosmolar syndrome.
- Differential diagnosis for HHS triggers requires thorough investigation.
Implications:
- Accurate identification of precipitating factors in HHS is crucial for effective treatment.
- Clinicians should consider a broad range of potential causes, including multiple infections.
- Further research into the multifactorial etiology of HHS may improve patient outcomes.