title: A 71-year-old man with hyperglycemia and mental status changes.
abstract: Hyperglycemic hyperosmolar syndrome is an extreme but relatively common presentation of uncontrolled or new-onset diabetes mellitus. The diagnosis of the disorder itself is fairly straightforward, but the search for an underlying cause can be challenging. Infections are the usual precipitating factor, but a variety of other stressors can be involved. We report herein a patient presenting with hyperglycemic hyperosmolar coma with three possible precipitating infections: pharyngitis, urinary tract infection, and infective endocarditis.
authors.affiliation: Louisiana State University Health Sciences Center, Family Practice Residency Program, New Orleans, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Naquin
authors.forename: Malini
authors.initials: M
authors.lastname: Kumar
authors.forename: Harry
authors.initials: H
authors.lastname: Chen
authors.forename: Roger
authors.initials: R
authors.lastname: Zoorob
authors.forename: Fred A
authors.initials: FA
authors.lastname: Lopez
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004452:Echocardiography; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000209:etiology*; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D010612:Pharyngitis / Q000209:etiology; D013577:Syndrome; D014552:Urinary Tract Infections / Q000209:etiology