Diagnostic features of diabetes with sepsis, liver abscess and endophthalmitis
Tang You1, Zheng Pingping1, Hui Cancan2, Lu Yating3, Wang Lin3, Deng Datong3
1Department of General Practice, 2Department of Endocrinology, 3Department of Geriatric Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
Abstract：ObjectiveTo explore the diagnostic features of diabetes with sepsis, liver abscess, and endophthalmitis. MethodsThe clinical data of a patient with diabetes, sepsis, liver abscess, and endophthalmitis admitted to the Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University on June 8, 2020 were retrospectively analyzed, and its diagnostic characteristics were summarized. ResultsThe 68-year-old male patient was admitted to the hospital due to "polyuria and polydipsia for 10 years, general fatigue and fever for more than 1 week". He has had type 2 diabetes for more than 10 years. The patient developed general fatigue, nausea and vomiting, fever accompanied by chills, blurred vision in the right eye for more than 1 week. Blood routine examination showed WBC 26.52×109/L, and neutrophil ratio of 0.91. Random blood glucose was 23.62mmol/L, and HbA1c was 11.40%. Routine urine examination showed glucose (3+) and ketone body (3+). CRP level was 81.36mg/L, PCT level was 3.20μg/L. Blood culture showed Klebsiella pneumoniae. Plain CT scan of the abdomen showed a lobular hypodensity lesion on the right side of the liver, suggesting liver abscess. Ultrasonography showed endophthalmitis and cellulitis in the right orbit. The patient was diagnosed as diabetic ketoacidosis, complicated with sepsis, liver abscess, and endophthalmitis defined as a bloodborne intraocular infection caused by liver abscess. ConclusionsDiabetes combined sepsis, liver abscess and endophal inflammation is a relatively rare and critical complication. The clinical symptoms are not typical and it is easily to be missed and misdiagnosed. Medical staff should strengthen the awareness of this disease to make timely diagnosis and treatment.
