Diabetes mellitus and its complications: case report

Česká verze

Authors: Na? A Hučková; Laura Gužiková; Peter Sabaka; Jana Hodulíková; Ľudovít Gašpar
Authors place of work: II. interná klinika LF UK a UNB v Bratislave, prednosta doc. MUDr. Ľudovít Gašpar, CSc.
Published in the journal: Forum Diab 2013; 2(1): 36-40
Category: Kazuistika

Summary

Case report describes 53 years old longtime diabetic patient, hospitalized due to unhealed defect in the right lower extremity, fever and shortness of breath. When patient was admitted, complained about pain and swelling of the right lower extremity, defect with excretion of pus. Associated with shortness of breath and fever up to 39 °C. Laboratory findings revealed increased kidney parameters and inflammation indicators. Differential diagnosis of dyspnea was realized in cooperation with pulmonologist during hospitalilzation while empirical antibiotics treatment was continued. On the ninth day of hospitalization occurred unexpected collapse with loss of consciousness and development of ventricular fibrillation, therefore cardiopulmonary resuscitation was performed immediately, which was successful - vital functions and consciousness of the patient were restored. After temporal improvement of patient´s condition further inpatient period was complicated with the development of right lower limb phlegmona followed by systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS). The patient underwent acute hemodialysis and antibiotic treatment was changed according to microbiological sensitivity. In spite of improved clinical status and laboratory results, the patient´s condition deteriorated progressively and on the 40th day of hospitalization cardiopulmonary failure occurred. The second cardiopulmonary resuscitation was not successful and the patient died.

Key words:
diabetes mellitus – multiorganomultivascular arterial disease – ventricular fibrilation

Zdroje

1. Mokáň M et al. Vnútorné lekárstvo. 3. diel. Bratislava: Vydavateľstvo UK 2005. ISBN 80–223–1895–7.

2. Gavorník P. Ateroskleróza a iné choroby tepien. Bratislava: Vydavateľstvo UK 1999. ISBN 80–223–1422–6.

3. Gavorník P. Diabetic angiopathy – etiopathogenesis and clinical manifestation (hypersyndrome X). Brat Lek Listy 2000; 101(10): 569–576.

4. Gavorník P. Artériová hypertenzia – circulus vitiosus vasorum. Medikom/MediNews 2012; 2(2): 12–18.

5. Gavorník P, Galbavý Š. Clinical picture of arteriolosclerosis. Brat Lek Listy 2001; 102(7): 326–331.

6. Gavorník P. Všeobecná angiológia. 2. rozšírené a doplnené vyd. Bratislava: Vydavateľstvo UK 2001. ISBN 80–223–1608–3.

7. Gavorník P. Vaskulárna endotelová dysfunkcia – etiopatogenéza, základné diagnostické metódy a liečebné možnosti. Všeob Angiol 2002; 2(2): 59–66.

8. Gavorník P. Hypersyndróm X (syndróm „iks“ alebo „desať“). Diabetik 2003; 1(1): 4–7.

9. Gavorník P. Končatinovocievne ischemické choroby. In: Gavorník, P, Hrubiško M, Roborilová E (eds). Diferenciálna diagnostika kardio-vaskulárnych, respiračných a hematologických ochorení. Bratislava: Dr. Josef Raabe 2010. ISBN 978–80–89182–46–6.

10. Gavorník P. Obliterujúce choroby artérií a končatinovocievna ischemická choroba. Nová klinicko-etiologicko-anatomicko-patofyziologická (CEAP) klasifikácia. Cardiology 2010; 19(3): 201–213.

11. Gavorník P. Etiopatogenéza neurovaskulárnych ischemických chorôb (syndrómov). Neurológia 2010; 5(2): 61–68.

12. Murín J, Yaghy M. Diabetes a vaskulárne poškodenie. Vnitř Lék 2009; 55(9): 788–791.

13. Dukát A et al. Diabetes mellitus a hypertenzia – letálne duo. Forum Diab 2012; 1(2–3): 86–91.

14. Macháček J. Aktuální názory na terapii hypertenze u pacientů s diabetes mellitus. Interní Med 2012; 14(5): 195–198.