Chonnam Med J.  1996 Jun;32(1):41-47.

A Case of Non-ketotic Hyperosomolar Coma associated with Pyogenic Liver Abscess and Multiple Septic Pulmonary Emboli in NIDDM

Affiliations
  • 1Department of Internal Medicine, Chonnam National University Medical School, Kwangju, Korea.
  • 2Department of Internal Medicine, Chonnam Hospital, Kwangju, Korea.

Abstract

Because of decreased host immunity, poorly controlled diabetic patients are susceptible to infections of the urinary tract, respiratory tract and skin, etc. Although the source of the liver abscess was not found frequently, diabetes mellitus was a frequent underlying condition. Although a relationship between pyogenic liver abscess and diabetes has not been proved, it has been suggested that persons with diabetes have a defect in host-defense mechanisms that make them more susceptible to the development of pyogenic liver abscess. While drainage-either percutaneous with pigtail catheter kept in place or surgical-remains the mainstay of therapy for liver abscesses, there is growing interest in medical management alone for pyogenic liver abscesses. We report a 72-year-old woman with NIDDM patient complicated with non-ketotic hyperosmolar coma. A blood culture grew K. pneumoniae. Ultrasonogram revealed about 10cm-sized abscess cavity and the chest PA revealed multiple septic emboli. She improved with medical treatment. Repeat Ultrasound showed a normal liver and chest PA was also normal.

Keyword

liver abscess and multiple septic emboli; diabetes

MeSH Terms

Abscess
Aged
Catheters
Coma*
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Female
Humans
Liver
Liver Abscess
Liver Abscess, Pyogenic*
Pneumonia
Respiratory System
Skin
Thorax
Ultrasonography
Urinary Tract
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