Case Analysis of Refractory Diabetic Ketoacidosis Combined with Pyogenic Liver Abscess

XIN Cai-hong; LUO Wei-guang; XIN Yue-ying; KUANG Jin-song

doi:10.3969/j.issn.1002-3429.2015.12.007

Abstract：Objective To investigate clinical characteristics of refractory diabetic ketoacidosis combined with pyogenic liver abscess patients so as to raise awareness of the disease. Methods Retrospective analysis on clinical data of one case of di-abetic ketoacidosis combined with pyogenic liver abscess was made and the literature was reviewed. Results The 51-year-old female patient had suffered from and had type 2 diabetes no system treatment for 5 years before admission. The patient com-plained of abdominal distention, abdominal pain and difficulty in breathing, and the patient had obvious high serum glucose con-centrations (31. 5 mmol/L), and carbon dioxide combining power was low (7. 3 mmol/L), and she was diagnosed as having di-abetic ketoacidosis. After the blood sugar and fluid treatment, her condition did not improve obviously. History inquiry showed that the patient's liver contusion had carried heavy things. Liver CT examination showed pyogenic liver abscess and growth of Klebsiella pneumonia in cultures. Percutaneous needle aspiration and percutaneous catheter drainage were performed. Antibiotics were reasonablely used to control blood sugar and fluid according to the drug ( drug resistance) test results, and diabetic ketoaci-dosis was corrected. CT shown that the abscess cavity closed narrow, and the patient was discharged after her symptoms were re-lieved remarkably. Conclusion When refractory diabetic ketoacidosis is hard to correct, clinicians should look carefully for the cause of the disease. The clinical presentations of secondary pyogenic liver abscess in diabetic patients are atypical, and rates of misdiagnosis and missed diagnosis are high. Therefore, early diagnosis and treatment is the key for cure.