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Published on: February 9, 2011
Pediatric diabetic ketoacidosis presenting with Streptococcus intermedius brain abscess
Judy L Mintz1, Morghan B Jameson1, Leah Akinseye2
1East Tennessee State University James H Quillen College of Medicine, Johnson City, Tennessee, USA.
Objectives:
Report a novel case of new-onset type 1 diabetes in a pediatric patient presenting with DKA and concurrent Streptococcus intermedius brain abscess.
Case Presentation:
The following case report is that of a previously healthy 12 year-old girl presenting with new-onset type 1 diabetes with mild diabetic ketoacidosis and subsequently found to have a brain abscess. Over the course of her hospital stay, she developed seizures and was found to have a 1.3 × 1.0 × 1.2 cm right frontal parasagittal mass culture-positive for S. intermedius. Neurologic symptoms were unmasked once insulin treatment was initiated and ketosis improved, supporting the relationship between therapeutic ketosis and the management of medication-refractory epilepsy.
Conclusions:
This case both supports the relationship between therapeutic ketosis and the management of medication-refractory epilepsy and highlights the need to carefully consider comorbid conditions in patients with DKA and new onset neurological symptoms.
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