JL. Mintz, MB. Jameson, L. Akinseye and EA. Los (2021). Pediatric diabetic ketoacidosis presenting with Streptococcus intermedius brain abscess. Journal of pediatric endocrinology & metabolism : JPEM, 34(6), 817-820. https://doi.org/10.1515/jpem-2020-0711

PubMed 33851524

[Abstract]
OBJECTIVES: Report a novel case of new-onset type 1 diabetes in a pediatric patient presenting with DKA and concurrent Streptococcus intermedius brain abscess.

CASE PRESENTATION: The following case report is that of a previously healthy 12 year-old girl presenting with new-onset type 1 diabetes with mild diabetic ketoacidosis and subsequently found to have a brain abscess. Over the course of her hospital stay, she developed seizures and was found to have a 1.3 × 1.0 × 1.2 cm right frontal parasagittal mass culture-positive for S. intermedius. Neurologic symptoms were unmasked once insulin treatment was initiated and ketosis improved, supporting the relationship between therapeutic ketosis and the management of medication-refractory epilepsy.

CONCLUSIONS: This case both supports the relationship between therapeutic ketosis and the management of medication-refractory epilepsy and highlights the need to carefully consider comorbid conditions in patients with DKA and new onset neurological symptoms.