Uncontrolled diabetic ketoacidosis can lead to brain stem infarct and death; a case report

  • Nur Jihan Mohd Zukhi
  • Mohd Zulfakar Mazlan
  • Fatanah Mohamad Suhaimi
Keywords: Diabetic ketoacidosis, Stroke, Brain stem infarct, Cerebral edema, Mortality

Abstract

Diabetic ketoacidosis (DKA) is a triad of hyperglycemia, metabolic acidosis and ketosis. It is a life-threatening complication of diabetes mellitus (DM) that can lead to death without appropriate treatment. DKA with stroke increases morbidity and mortality in the intensive care unit (ICU). A 37-year-old male was brought to the emergency department with sudden onset of weakness for the past two days. He had been diagnosed with type 2 DM five years earlier, but it was poorly controlled. On examination, his Glasgow Coma Scale was within normal limits. Laboratory and radiological investigations revealed severe hyperglycemia, metabolic acidosis, and brain stem infarct. He required intubation and was admitted to the ICU with a diagnosis of DKA and cerebellar and brain stem infarct. The patient succumbed to death despite 13 days of ICU management. DKA can precipitate a cerebellar and brain stem infarct, but it can be fatal despite extreme management in the ICU.

Abbreviations: DKA - Diabetic ketoacidosis; DM - Diabetes mellitus; ICU - Intensive care unit; CED - Cerebral edema; ED - Emergency department

Key words: Diabetic ketoacidosis; Stroke; Brain stem infarct; Cerebral edema; Mortality

Citation: Zukhi NJM, Mazlan MZ, Suhaimi FM. Uncontrolled diabetic ketoacidosis can lead to brain stem infarct and death; a case report. Anaesth. pain intensive care 2022;26(2):253-256; DOI: 10.35975/apic.v26i2.1808

Received: December 24, 2021; Reviewed: February 07, 2022; Accepted: February 07, 2022

Author Biographies

Nur Jihan Mohd Zukhi

Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia

Mohd Zulfakar Mazlan

Department of Anesthesiology and Intensive Care, School of Medical Science, Universiti Sains Malaysia, Kubang Kerian, 15200 Kota Bharu, Kelantan, Malaysia

Fatanah Mohamad Suhaimi

Fatanah Mohamad Suhaimi, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia

Published
09-03-2022
How to Cite
Mohd Zukhi, N., Mazlan, M., & Suhaimi, F. (2022). Uncontrolled diabetic ketoacidosis can lead to brain stem infarct and death; a case report. Anaesthesia, Pain & Intensive Care, 26(2), 253-256. https://doi.org/10.35975/apic.v26i2.1808
Section
Case Reports

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