| Dengue hemorrhagic fever grade III with diabetic ketoacidosis: a case report. | |
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MedLine Citation:
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PMID: 22043783 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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A 16-year-old, previously healthy Thai girl presented with DHF grade III. Fifteen hours after the first episode of shock, she had received an excessive amount of crystalloid isotonic solution and 20 ml per kilograms of Dextran-40 however she still had persistently rapid pulse rate and high hematocrit but also had polyuria with more than 4 ml/kg/hr of urine output. She was re-evaluated. Clinical signs showed severe dehydration with some ascites without signs of pleural effusion. Blood gas revealed increased anion gap metabolic acidosis. The cause of polyuria and metabolic acidosis was identified with hyperglycemia, ketouria and glucosuria. Afterwards she was diagnosed and treated as DHF grade III and DKA. Besides insulin administration, fluid resuscitation was very crucial. Intravenous fluid rehydration was needed while the unnecessary extra-volume could cause massive plasma leakage and later on fluid overload. Volume replacement was adjusted to degree of dehydration when signs of volume overload were monitored closely. She was out of DKA at 14 hours after the start of insulin and the intravenous fluid was stopped at 27 hours (36 hours after the first episode of shock). The final diagnosis was DHF grade III, diabetes mellitus with DKA and hepatitis. |
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Authors:
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Pra-on Supradish; Nuanphong Rienmanee; Adidsuda Fuengfoo; Siripen Kalayanarooj |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the Medical Association of Thailand = Chotmaihet thangphaet Volume: 94 Suppl 3 ISSN: 0125-2208 ISO Abbreviation: J Med Assoc Thai Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7507216 Medline TA: J Med Assoc Thai Country: Thailand |
Other Details:
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Languages: eng Pagination: S233-40 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand. praonsu@yahoo.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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