A 71-year-old man with hyperglycemia and mental status changes.
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.
Naquin
Christopher
C
Louisiana State University Health Sciences Center, Family Practice Residency Program, New Orleans, USA.
Kumar
Malini
M
Chen
Harry
H
Zoorob
Roger
R
Lopez
Fred A
FA
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